Sandbox restrictive

Disease		Clinical manifestations											Diagnosis
		Symptoms				Physical exam							Lab findings	Imaging			Gold standard
		Cough	Dyspnea	Hemoptysis	Fever	History/Exposure	Cyanosis	Clubbing	JVD	Peripheral edema	Auscultation	Other prominent findings		CXR	CT	DLCco
Acute Respiratory Distress Syndrome (ARDS)		-	+	-	-	Inciting event, such as: Trauma Sepsis Drug overdose Massive transfusion Acute pancreatitis Aspiration	+	-	-	-	Coarse breath sounds Rhonchi crackles Decreased breath sounds	Initially respiratory alkalosis transforming to respiratory acidosis	BNP level of less than 100 pg/mL PaO2 / FiO2 <300 CBC Leukopenia Leukocytosis Thrombocytopenia	Bilateral pulmonary infiltrates Initially patchy peripheral Later diffuse bilateral Ground glass Frank alveolar infiltrate	Bronchial dilatation within areas of ground-glass opacification
Bronchitis	Acute	+	-	+/-	+	-	-	-	-	-	Diffuse wheezes High-pitched continuous sounds The use of accessory muscles  Prolonged expiration Rhonchi Rales	Hoarseness	N/A	Normal	N/A		Clinical diagnosis
	Chronic	+	+	-	-	A positive history of chronic productive cough  Shortness of breath	+	-	+	+	Prolonged expiration; wheezing Diffusely decreased breath sound Coarse crackles with inspiration Coarse rhonchi		Chronic hypoxemia may lead to polycythemia  Increase in Neutrophils count Chronic respiratory acidosis. To compensate for this, the body may develop metabolic alkalosis	Radiolucency Diaphragmatic flattening due to hyperinflation Increased retrosternal airspace on the lateral radiograph	N/A
Hypersensitivity Pneumonitis		+	+	-	+	History of allergen exposure	-	+	-	-	Diffuse fine bibasilar crackles	Constitutional symptoms Weight loss Anorexia Muscle weakness	Neutrophilia Elevated ESR Elevated CRP Elevated immunoglobulin No peripheral blood eosinophilia	Poorly defined micronodular or diffuse interstitial pattern In chronic form Fibrosis Loss of lung volume Coarse linear opacities	Ground-glass opacities or Diffusely increased radiodensities Diffuse micronodules Focal air trapping Mosaic perfusion Occasionaly thin-walled cysts Mild fibrotic changes
Pneumoconiosis	SIlicosis	+	+	+/-	-	History of substantial exposure to silica dusts Occupational history Sandblasting Bystanders Quartzite miller Tunnel workers Silica flour workers Workers in the scouring powder industry	+	+	+	-	Lungs are hyperresonant Finecrackles upon auscultation of the lung bases or apices, unilaterally or bilaterally Rhonchi Bronchial breath sounds Expiratory wheezing with normal or delayed expiratory phase Wheezing may be present Egophony present Bronchophony present Increased tactile fremitus.	Increased susceptiblity to tuberculosis.	Abnormal ABG May indicate hypoxia, hypercapnia and respiratory acidosis Abnormal sputum analysis May contain bacteria, such as mycobacterium tuberculosis or inorganic particles, such as asbestos bodies or organic particles Peak flow assessment May be below normal range which is 100 liters/minute for men, and 80 liters/minute for women Spirometry May indicate an obstructive or restrictive pulmonary disease A FEV1/FVC ratio < 80% indicates and obstructive disease,such as asthma, whilst a FEV1/FVC ratio higher than restrictive pulmonary disease indicates a restrictive disease, such as pulmonary fibrosis CBC May indicate anemia, neutrophilia, elevated ESR, elevated CRP, and elevated immunoglobulin Bronchoscopy and bronchoalveolar lavage May reveal mineral dust Tuberculin skin test To test for tuberculosis, and induration > 5mm is positive Stool examination for occult blood May indicate colorectal carcinoma	Small round opacities Symmetrically distributed Upper-zone predominance Diffuse interstitial pattern of fibrosis without the typical nodular opacities in chronic case	Nodular changes in lung parenchyma Progressive massive fibrosis Bullae, emphysema Pleural, mediastinal, and hilar changes		Clinical history Radiological findings
	Asbestosis											Lung cancer Mesothelioma		Predilection to lower lobes Fine and coarse linear, peripheral, reticular opacities
	Berylliosis													Multiple, rounded opacities with or without calcification Architectural distortion Loss of lung tissue volume Shadows Upper lobe predominance Chronic berylliosis shows emphysema with bulla formation
	Byssinosis
Eosinophilic Pneumonia	Acute	+	+	-	+
	Loffler syndrome
	Chronic
Sarcodiosis
Pleural Effusion
Myasthenia gravis
Scoliosis
Neuromuscular disease	Muscular dystrophy
	ALS
Interstitial (Nonidiopathic) Pulmonary Fibrosis		+	++	+	-	Connective-tissue disorder Pneumoconiosis	+	+	+	+	Wheezing S3 P2 End-inspiratory rales	Increased A-a gradient	Elevated ESR Serologic testing for ANA, RF, ANCA & ASCA may be positive	Reticular and/or nodular opacities Honeycomb appearance (late finding)	Bilateral reticular and nodular interstitial infiltrates	↓	Video-assisted thoracoscopic lung biopsy
Lymphocytic Interstitial Pneumonia		+	+	+	+	Autoimmune Lymphoproliferative disorders	-	+	-	-	Wheezing Rales	Increased A-a gradient	Polyclonal hypergammaglobulinemia Increased LDH	Bibasilar interstitial or micronodular infiltrates	Determines the degree of fibrosis Cysts (characterstic)	N	Open lung biopsy
Obesity		+	+	-	-	Overweight Diabetes mellitus Asthma	-	-	-	+	Wheezing		Increased hematocrit	X ray findings are often limited due to body habitus	CT findings are variable and depends upon severity of obesity	N
Pulmonary Eosinophilia		+	+	+	+	Infections Prasitic Fungal Mycobacterial	+	-	+	+	Wheezing Rales	Increased A-a gradient	Leukocytosis with eosinophilia (> 250/µL)	Interstitial or diffuse nodular densities	Determines extent and distribution of the disease Interstitial infiltrates Cysts and nodules	↓	Biopsy of lesion (skin or lung)