Altitude sickness differential diagnosis: Difference between revisions

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==Overview==
==Overview==
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==Differential diagnosis==
==Differential diagnosis==
<small>'''''Abbreviations:''''' '''ABG ('''[[arterial blood gas]]'''); ACE ('''[[Angiotensin-converting enzyme|angiotensin converting enzyme]]'''); BMI ('''[[body mass index]]'''); CBC ('''[[Complete blood counts|complete blood count]]'''); CSF ('''[[cerebrospinal fluid]]'''); CXR ('''[[chest X-ray]]'''); ECG ('''[[electrocardiogram]]'''); FEF ('''[[Spirometry|forced expiratory flow rate]]'''); FEV1 ('''[[forced expiratory volume]]'''); FVC ('''[[forced vital capacity]]'''); JVD ('''[[jugular vein distention]]''');''' '''MCV ('''[[mean corpuscular volume]]'''); Plt ('''[[platelet]]'''); RV ('''[[residual volume]]'''); SIADH ('''[[syndrome of inappropriate antidiuretic hormone]]'''); TSH ('''[[thyroid stimulating hormone]]'''); Vt ('''[[tidal volume]]''');''' '''WBC ('''[[White blood cells|white blood cell]]''');'''</small>
<small><small>
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! colspan="3" rowspan="3" |Organ system
! rowspan="3" |Diseases
! colspan="11" |Clinical manifestations
! colspan="5" rowspan="2" |Diagnosis
! rowspan="3" |Other features
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! colspan="6" |Symptoms
! colspan="5" |Physical exam
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Loss of consciousness
!Agitation
!Weight loss
!Fever
!Chest pain
!Cough
!Cyanosis
!Clubbing
!JVD
!Peripheral edema
!Auscultation
!CBC
!ABG
!Imaging
!Spirometry
!Gold standard
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
! rowspan="5" |Acute Dyspnea
! rowspan="4" |[[Respiratory system]]
! rowspan="4" |[[Chest]] and [[Pleurae|Pleura]],
Lower [[airway]]
![[Bronchiolitis]]<ref name="pmid23562737">{{cite journal |vauthors=Holbro A, Lehmann T, Girsberger S, Stern M, Gambazzi F, Lardinois D, Heim D, Passweg JR, Tichelli A, Bubendorf L, Savic S, Hostettler K, Grendelmeier P, Halter JP, Tamm M |title=Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation |journal=Biol. Blood Marrow Transplant. |volume=19 |issue=6 |pages=973–80 |year=2013 |pmid=23562737 |doi=10.1016/j.bbmt.2013.03.017 |url=}}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]] and [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Bronchovascular markings
! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]]
! style="background: #F5F5F5; padding: 5px;" |[[Clinical]] assessment
! style="background: #F5F5F5; padding: 5px;" |[[Respiratory syncytial virus|Respiratory syncytial virus (RSV)]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[COPD exacerbation resident survival guide|COPD exacerbation]]<ref name="pmid25177479">{{cite journal| author=Qureshi H, Sharafkhaneh A, Hanania NA| title=Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. | journal=Ther Adv Chronic Dis | year= 2014 | volume= 5 | issue= 5 | pages= 212-27 | pmid=25177479 | doi=10.1177/2040622314532862 | pmc=4131503 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25177479  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]], [[Rhonchi]], and [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], ↑[[RBC]]
! style="background: #F5F5F5; padding: 5px;" |[[Respiratory alkalosis]]
! style="background: #F5F5F5; padding: 5px;" |Hyperexpansion
! style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1]]/[[FVC]]
! style="background: #F5F5F5; padding: 5px;" |[[Clinical]] assessment
! style="background: #F5F5F5; padding: 5px;" |[[Chronic bronchitis|Acute '''exacerbations''' of chronic bronchitis (AECB)]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Lung carcinoma]]<ref name="pmid22054876">{{cite journal| author=Dela Cruz CS, Tanoue LT, Matthay RA| title=Lung cancer: epidemiology, etiology, and prevention. | journal=Clin Chest Med | year= 2011 | volume= 32 | issue= 4 | pages= 605-44 | pmid=22054876 | doi=10.1016/j.ccm.2011.09.001 | pmc=3864624 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22054876  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]] and [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Mass lesion, [[hilar lymphadenopathy]]
! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
! style="background: #F5F5F5; padding: 5px;" |[[Bronchoscopy]]
! style="background: #F5F5F5; padding: 5px;" |Paraneoplastic syndromes, such as [[Syndrome of inappropriate antidiuretic hormone|SIADH]] and [[Lambert-Eaton myasthenic syndrome|lambert-Eaton]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Pneumonia]]<ref name="pmid25165554">{{cite journal| author=Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J| title=Management of community-acquired pneumonia in older adults. | journal=Ther Adv Infect Dis | year= 2014 | volume= 2 | issue= 1 | pages= 3-16 | pmid=25165554 | doi=10.1177/2049936113518041 | pmc=4072047 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25165554  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]], [[Rhonchi]], and [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], [[neutrophilia]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Consolidation (medicine)|Lobar consolidation]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Chest X-ray]] and CT Scan
! style="background: #F5F5F5; padding: 5px;" |[[productive cough]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
! colspan="2" |[[Cardiovascular system]]
![[Pulmonary edema]]<ref name="MartindaleNoble2013">{{cite journal|last1=Martindale|first1=Jennifer L.|last2=Noble|first2=Vicki E.|last3=Liteplo|first3=Andrew|title=Diagnosing pulmonary edema|journal=European Journal of Emergency Medicine|volume=20|issue=5|year=2013|pages=356–360|issn=0969-9546|doi=10.1097/MEJ.0b013e32835c2b88}}</ref>
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |Basal [[Crackles|crackle]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Respiratory alkalosis]]
! style="background: #F5F5F5; padding: 5px;" |Bat wing pattern, air bronchograms
! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
! style="background: #F5F5F5; padding: 5px;" |[[Coronary catheterization|Cardiac Catheterization]]
! style="background: #F5F5F5; padding: 5px;" |[[Tachypnea]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
! rowspan="7" |Chronic Dyspnea
! rowspan="6" |[[Respiratory system]]
! rowspan="6" |[[Chest]] and [[Pleura]],
Lower [[airway]]
![[Bronchiectasis]]<ref name="CantinBankier2009">{{cite journal|last1=Cantin|first1=Luce|last2=Bankier|first2=Alexander A.|last3=Eisenberg|first3=Ronald L.|title=Bronchiectasis|journal=American Journal of Roentgenology|volume=193|issue=3|year=2009|pages=W158–W171|issn=0361-803X|doi=10.2214/AJR.09.3053}}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]], [[Wheezing]], [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], [[neutrophilia]]
! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
! style="background: #F5F5F5; padding: 5px;" |[[Bronchiectasis chest x ray|Tram-track opacities]]
! style="background: #F5F5F5; padding: 5px;" |↑ [[FEV1]]/[[FVC]]
! style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|High resolution computed tomography (HRCT)]]
! style="background: #F5F5F5; padding: 5px;" |[[Productive cough|Chronic productive cough]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Interstitial lung disease]]<ref name="pmid2060395">{{cite journal |vauthors=Baughman RP, Shipley RT, Loudon RG, Lower EE |title=Crackles in interstitial lung disease. Comparison of sarcoidosis and fibrosing alveolitis |journal=Chest |volume=100 |issue=1 |pages=96–101 |year=1991 |pmid=2060395 |doi= |url=}}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]], [[Wheezing]], [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
! style="background: #F5F5F5; padding: 5px;" |Peripheral [[pulmonary]] infiltrative opacification
! style="background: #F5F5F5; padding: 5px;" |↑ [[FEV1]]/[[FVC]]
! style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|High resolution computed tomography (HRCT)]]
! style="background: #F5F5F5; padding: 5px;" |[[Pneumoconiosis]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Sarcoidosis]]<ref name="pmid14518232">{{cite journal |vauthors=Moher D, Cole CW, Hill GB |title=Epidemiology of abdominal aortic aneurysm: the effect of differing definitions |journal=Eur J Vasc Surg |volume=6 |issue=6 |pages=647–50 |date=November 1992 |pmid=1451823 |doi= |url= |author=}}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
! style="background: #F5F5F5; padding: 5px;" |[[Hilar lymphadenopathy|Hilar adenopathy]]
! style="background: #F5F5F5; padding: 5px;" |↑ [[FEV1]]/[[FVC]]
! style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|High resolution computed tomography (HRCT)]]
! style="background: #F5F5F5; padding: 5px;" |[[Hypercalcemia]], high [[Angiotensin-converting enzyme|ACE]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Alveolitis]]<ref name="pmid15692967">{{cite journal |vauthors=Khanna D, Clements PJ, Furst DE, Chon Y, Elashoff R, Roth MD, Sterz MG, Chung J, FitzGerald JD, Seibold JR, Varga J, Theodore A, Wigley FM, Silver RM, Steen VD, Mayes MD, Connolly MK, Fessler BJ, Rothfield NF, Mubarak K, Molitor J, Tashkin DP |title=Correlation of the degree of dyspnea with health-related quality of life, functional abilities, and diffusing capacity for carbon monoxide in patients with systemic sclerosis and active alveolitis: results from the Scleroderma Lung Study |journal=Arthritis Rheum. |volume=52 |issue=2 |pages=592–600 |date=February 2005 |pmid=15692967 |doi=10.1002/art.20787 |url= |author=}}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |Basal [[Crackles|crackle]]
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], [[neutrophilia]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" | Basal reticulonodular opacification 
! style="background: #F5F5F5; padding: 5px;" |↑ [[FEV1]]/[[FVC]]
! style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|High resolution computed tomography (HRCT)]]
! style="background: #F5F5F5; padding: 5px;" |[[Dry cough]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Cystic fibrosis]]<ref name="ZieglerRovedder2009">{{cite journal|last1=Ziegler|first1=Bruna|last2=Rovedder|first2=Paula Maria Eidt|last3=Dalcin|first3=Paulo de Tarso Roth|last4=Menna-Barreto|first4=Sérgio Saldanha|title=Padrões ventilatórios na espirometria em pacientes adolescentes e adultos com fibrose cística|journal=Jornal Brasileiro de Pneumologia|volume=35|issue=9|year=2009|pages=854–859|issn=1806-3713|doi=10.1590/S1806-37132009000900006}}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]], [[Wheezing]], [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Metabolic alkalosis]]
! style="background: #F5F5F5; padding: 5px;" |Thick-walled [[bronchiectasis]]
! style="background: #F5F5F5; padding: 5px;" |↓ [[Forced expiratory volume|FEF<sub>75%</sub>]]/[[FVC]]
! style="background: #F5F5F5; padding: 5px;" |[[Sweat test]]
! style="background: #F5F5F5; padding: 5px;" |[[Congenital absence of the vas deferens|Absent vas deferens]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Tuberculosis]]<ref name="pmid16709993">{{cite journal| author=Campbell IA, Bah-Sow O| title=Pulmonary tuberculosis: diagnosis and treatment. | journal=BMJ | year= 2006 | volume= 332 | issue= 7551 | pages= 1194-7 | pmid=16709993 | doi=10.1136/bmj.332.7551.1194 | pmc=1463969 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16709993  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]], [[Wheezing]], [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
! style="background: #F5F5F5; padding: 5px;" |Patchy [[Consolidation (medicine)|consolidation]] or poorly defined linear and nodular [[Opacity|opacities]]
! style="background: #F5F5F5; padding: 5px;" |[[Restrictive Lung Disease|Restrictive]], [[Obstructive lung disease|obstructive]], or mixed
! style="background: #F5F5F5; padding: 5px;" |[[Interferon-γ release assays|IFN-γ release assay (IGRA)]]
[[Acid fast|Acid-fast staining]]
! style="background: #F5F5F5; padding: 5px;" |[[Night sweat]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
! colspan="2" |[[Autoimmune]]
![[Wegener's granulomatosis]]<ref name="pmid23034218">{{cite journal| author=Cardenas-Garcia J, Farmakiotis D, Baldovino BP, Kim P| title=Wegener's granulomatosis in a middle-aged woman presenting with dyspnea, rash, hemoptysis and recurrent eye complaints: a case report. | journal=J Med Case Rep | year= 2012 | volume= 6 | issue=  | pages= 335 | pmid=23034218 | doi=10.1186/1752-1947-6-335 | pmc=3492078 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23034218  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Wheezing]], [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |↓ [[RBC]]
! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
! style="background: #F5F5F5; padding: 5px;" |Cavitate [[nodules]], ground-glass opacity
! style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1]]/[[FVC]]
! style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] demonstrating a [[granulomatous]] [[vasculitis]]
! style="background: #F5F5F5; padding: 5px;" |[[Rhinosinusitis|Chronic rhinosinusitis]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
|}
</small></small>


==References==
==References==

Revision as of 19:36, 10 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Differential diagnosis

Abbreviations: ABG (arterial blood gas); ACE (angiotensin converting enzyme); BMI (body mass index); CBC (complete blood count); CSF (cerebrospinal fluid); CXR (chest X-ray); ECG (electrocardiogram); FEF (forced expiratory flow rate); FEV1 (forced expiratory volume); FVC (forced vital capacity); JVD (jugular vein distention); MCV (mean corpuscular volume); Plt (platelet); RV (residual volume); SIADH (syndrome of inappropriate antidiuretic hormone); TSH (thyroid stimulating hormone); Vt (tidal volume); WBC (white blood cell);

Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Loss of consciousness Agitation Weight loss Fever Chest pain Cough Cyanosis Clubbing JVD Peripheral edema Auscultation CBC ABG Imaging Spirometry Gold standard
Acute Dyspnea Respiratory system Chest and Pleura,

Lower airway

Bronchiolitis[1] - - - + +/- + - - - - Wheeze and Crackles ↑WBC Normal Bronchovascular markings ↓Vt Clinical assessment Respiratory syncytial virus (RSV)
COPD exacerbation[2] - + - + + + + +/- +/- +/- Wheeze, Rhonchi, and Crackles ↑WBC, ↑RBC Respiratory alkalosis Hyperexpansion ↓ FEV1/FVC Clinical assessment Acute exacerbations of chronic bronchitis (AECB)
Lung carcinoma[3] - - + - - + + + - - Wheeze and Crackles Normal Normal Mass lesion, hilar lymphadenopathy ↓Vt, ↑RV Bronchoscopy Paraneoplastic syndromes, such as SIADH and lambert-Eaton
Pneumonia[4] - - - + + + - - - - Wheeze, Rhonchi, and Crackles ↑WBC, neutrophilia Normal Lobar consolidation Normal Chest X-ray and CT Scan productive cough
Cardiovascular system Pulmonary edema[5] +/- + - + + + + + + + Basal crackle Normal Respiratory alkalosis Bat wing pattern, air bronchograms ↓Vt, ↑RV Cardiac Catheterization Tachypnea
Chronic Dyspnea Respiratory system Chest and Pleura,

Lower airway

Bronchiectasis[6] - - - + + + + + - - Rhonchi, Wheezing, Crackles ↑WBC, neutrophilia ↓O2, ↑CO2 Tram-track opacities ↑ FEV1/FVC High resolution computed tomography (HRCT) Chronic productive cough
Interstitial lung disease[7] - - - - + + + + - - Rhonchi, Wheezing, Crackles Normal ↓O2, ↑CO2 Peripheral pulmonary infiltrative opacification ↑ FEV1/FVC High resolution computed tomography (HRCT) Pneumoconiosis
Sarcoidosis[8] - - +/- - +/- + + - - - Crackles Normal ↓O2, ↑CO2 Hilar adenopathy ↑ FEV1/FVC High resolution computed tomography (HRCT) Hypercalcemia, high ACE
Alveolitis[9] - - - + + + - - - - Basal crackle ↑WBC, neutrophilia Normal Basal reticulonodular opacification ↑ FEV1/FVC High resolution computed tomography (HRCT) Dry cough
Cystic fibrosis[10] - - + + - +/- + + - - Rhonchi, Wheezing, Crackles Normal Metabolic alkalosis Thick-walled bronchiectasis ↓ FEF75%/FVC Sweat test Absent vas deferens
Tuberculosis[11] - - + + + + +/- - - - Rhonchi, Wheezing, Crackles ↑WBC ↓O2, ↑CO2 Patchy consolidation or poorly defined linear and nodular opacities Restrictive, obstructive, or mixed IFN-γ release assay (IGRA)

Acid-fast staining

Night sweat
Autoimmune Wegener's granulomatosis[12] - - +/- - - + - - - - Wheezing, Crackles ↓ RBC ↓O2, ↑CO2 Cavitate nodules, ground-glass opacity ↓ FEV1/FVC Biopsy demonstrating a granulomatous vasculitis Chronic rhinosinusitis

References

  1. ↑ Holbro A, Lehmann T, Girsberger S, Stern M, Gambazzi F, Lardinois D, Heim D, Passweg JR, Tichelli A, Bubendorf L, Savic S, Hostettler K, Grendelmeier P, Halter JP, Tamm M (2013). "Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation". Biol. Blood Marrow Transplant. 19 (6): 973–80. doi:10.1016/j.bbmt.2013.03.017. PMID 23562737.
  2. ↑ Qureshi H, Sharafkhaneh A, Hanania NA (2014). "Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications". Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.
  3. ↑ Dela Cruz CS, Tanoue LT, Matthay RA (2011). "Lung cancer: epidemiology, etiology, and prevention". Clin Chest Med. 32 (4): 605–44. doi:10.1016/j.ccm.2011.09.001. PMC 3864624. PMID 22054876.
  4. ↑ Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J (2014). "Management of community-acquired pneumonia in older adults". Ther Adv Infect Dis. 2 (1): 3–16. doi:10.1177/2049936113518041. PMC 4072047. PMID 25165554.
  5. ↑ Martindale, Jennifer L.; Noble, Vicki E.; Liteplo, Andrew (2013). "Diagnosing pulmonary edema". European Journal of Emergency Medicine. 20 (5): 356–360. doi:10.1097/MEJ.0b013e32835c2b88. ISSN 0969-9546.
  6. ↑ Cantin, Luce; Bankier, Alexander A.; Eisenberg, Ronald L. (2009). "Bronchiectasis". American Journal of Roentgenology. 193 (3): W158–W171. doi:10.2214/AJR.09.3053. ISSN 0361-803X.
  7. ↑ Baughman RP, Shipley RT, Loudon RG, Lower EE (1991). "Crackles in interstitial lung disease. Comparison of sarcoidosis and fibrosing alveolitis". Chest. 100 (1): 96–101. PMID 2060395.
  8. ↑ Moher D, Cole CW, Hill GB (November 1992). "Epidemiology of abdominal aortic aneurysm: the effect of differing definitions". Eur J Vasc Surg. 6 (6): 647–50. PMID 1451823.
  9. ↑ Khanna D, Clements PJ, Furst DE, Chon Y, Elashoff R, Roth MD, Sterz MG, Chung J, FitzGerald JD, Seibold JR, Varga J, Theodore A, Wigley FM, Silver RM, Steen VD, Mayes MD, Connolly MK, Fessler BJ, Rothfield NF, Mubarak K, Molitor J, Tashkin DP (February 2005). "Correlation of the degree of dyspnea with health-related quality of life, functional abilities, and diffusing capacity for carbon monoxide in patients with systemic sclerosis and active alveolitis: results from the Scleroderma Lung Study". Arthritis Rheum. 52 (2): 592–600. doi:10.1002/art.20787. PMID 15692967.
  10. ↑ Ziegler, Bruna; Rovedder, Paula Maria Eidt; Dalcin, Paulo de Tarso Roth; Menna-Barreto, Sérgio Saldanha (2009). "Padrões ventilatórios na espirometria em pacientes adolescentes e adultos com fibrose cística". Jornal Brasileiro de Pneumologia. 35 (9): 854–859. doi:10.1590/S1806-37132009000900006. ISSN 1806-3713.
  11. ↑ Campbell IA, Bah-Sow O (2006). "Pulmonary tuberculosis: diagnosis and treatment". BMJ. 332 (7551): 1194–7. doi:10.1136/bmj.332.7551.1194. PMC 1463969. PMID 16709993.
  12. ↑ Cardenas-Garcia J, Farmakiotis D, Baldovino BP, Kim P (2012). "Wegener's granulomatosis in a middle-aged woman presenting with dyspnea, rash, hemoptysis and recurrent eye complaints: a case report". J Med Case Rep. 6: 335. doi:10.1186/1752-1947-6-335. PMC 3492078. PMID 23034218.

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