Disease
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Clinical manifestations
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Diagnosis
|
Symptoms
|
Physical exam
|
Lab findings
|
Imaging
|
Gold standard
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Cough
|
Dyspnea
|
Hemoptysis
|
Fever
|
History/Exposure
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Cyanosis
|
Clubbing
|
JVD
|
Peripheral edema
|
Auscultation
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Other prominent findings
|
CXR
|
CT
|
|
Acute Respiratory Distress Syndrome (ARDS)
|
-
|
+
|
-
|
-
|
Inciting event, such as:
|
+
|
-
|
-
|
-
|
|
- 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
|
|
|
|
|
|
Chronic
|
+
|
+
|
-
|
-
|
- A positive history of chronic productive cough
- Shortness of breath
|
+
|
-
|
+
|
+
|
|
|
|
- Radiolucency
- Diaphragmatic flattening due to hyperinflation
- Increased retrosternal airspace on the lateral radiograph
|
N/A
|
|
Hypersensitivity Pneumonitis
|
+
|
+
|
-
|
+
|
- History of allergen exposure
|
-
|
+
|
-
|
-
|
|
- 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.
|
[1][2][3]
- 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
- 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
|
|
|
|
- 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
|
+
|
+
|
-
|
+
|
|
|
|
|
|
|
|
|
|
|
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Loffler syndrome
|
|
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Chronic
|
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Sarcodiosis
|
|
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Pleural Effusion
|
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Myasthenia gravis
|
|
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Neuromuscular disease
|
Muscular dystrophy
|
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ALS
|
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