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__NOTOC__
__NOTOC__
{| class="wikitable"
{| class="wikitable"
! rowspan="3" |Disease
! colspan="2" rowspan="3" |Disease
! colspan="11" |Clinical manifestations
! colspan="11" |Clinical manifestations
! colspan="7" |Diagnosis
! colspan="4" |Diagnosis
|-
|-
! colspan="4" |Symptoms
! colspan="4" |Symptoms
! colspan="7" |Physical exam
! colspan="7" |Physical exam
! colspan="2" |Lab findings
! rowspan="2" |Lab findings
! colspan="3" |Imaging
! colspan="2" |Imaging
!Gold standard
!Gold standard
!Other features
|-
|-
!Cough
!Cough
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!Auscultation
!Auscultation
!Other prominent findings
!Other prominent findings
!ABG
!Other
!CXR
!CXR
!CT
!CT
!DLC Co
!
!
!
|-
|-
|Acute Respiratory Distress Syndrome (ARDS)
| colspan="2" |Acute Respiratory Distress Syndrome (ARDS)
| -
| -
| +
| +
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* Rhonchi [[crackles]]  
* Rhonchi [[crackles]]  
* Decreased [[breath sounds]]
* Decreased [[breath sounds]]
|
*
*
|
|
* Initially respiratory alkalosis transforming to respiratory acidosis
* Initially respiratory alkalosis transforming to respiratory acidosis
*
|
|
* BNP level of less than 100 pg/mL
* BNP level of less than 100 pg/mL
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** Leukocytosis
** Leukocytosis
** Thrombocytopenia
** Thrombocytopenia
**
**
|
|
* Bilateral pulmonary infiltrates
* Bilateral pulmonary infiltrates
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|
* Bronchial dilatation within areas of ground-glass opacification
* Bronchial dilatation within areas of ground-glass opacification
|
|
|
|
|-
|-
|Acute Bronchitis
| rowspan="2" |Bronchitis
|Acute
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
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* [[Rales]]
* [[Rales]]
|
|
** [[Hoarseness]]
* [[Hoarseness]]
**
|
|
* N/A
* N/A
|
* Normal
|
|
* N/A
* N/A
|
|
* Normal
* 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]]
|
|
* N/A
|
|
* Chronic [[hypoxemia]] may lead to [[polycythemia]] 
* Increase in [[Neutrophil|Neutrophils]] count
* Chronic [[respiratory acidosis]]. To compensate for this, the body may develop [[metabolic alkalosis]] 
|
|
* Clinical diagnosis
* Radiolucency
* Diaphragmatic flattening due to hyperinflation
* Increased retrosternal airspace on the lateral radiograph
|N/A
|
|
|-
|-
|Hypersensitivity Pneumonitis
| colspan="2" |Hypersensitivity Pneumonitis
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
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** Anorexia
** Anorexia
** Muscle weakness
** Muscle weakness
|
|
|
* Neutrophilia
* Neutrophilia
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* Mild fibrotic changes 
* Mild fibrotic changes 
|
|
* Reduced
|-
| rowspan="4" |Pneumoconiosis
|SIlicosis
| rowspan="4" | +
| rowspan="4" | +
| rowspan="4" | +/-
| rowspan="4" | -
|
|
* History of substantial exposure to silica dusts
* Occupational history
** Sandblasting
** Bystanders
** Quartzite miller
** Tunnel workers
** Silica flour workers
** Workers in the scouring powder industry
| rowspan="4" | +
| rowspan="4" | +
| rowspan="4" | +
| -
| rowspan="4" |
**Lungs are hyperresonant
**Fine[[crackles]] 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.
| rowspan="4" |
*Abnormal ABG
<ref name="pmid16545629">{{cite journal |vauthors=du Bois RM |title=Evolving concepts in the early and accurate diagnosis of idiopathic pulmonary fibrosis |journal=Clin. Chest Med. |volume=27 |issue=1 Suppl 1 |pages=S17–25, v–vi |year=2006 |pmid=16545629 |doi=10.1016/j.ccm.2005.08.001 |url=}}</ref><ref name="pmid9563720">{{cite journal |vauthors=Gay SE, Kazerooni EA, Toews GB, Lynch JP, Gross BH, Cascade PN, Spizarny DL, Flint A, Schork MA, Whyte RI, Popovich J, Hyzy R, Martinez FJ |title=Idiopathic pulmonary fibrosis: predicting response to therapy and survival |journal=Am. J. Respir. Crit. Care Med. |volume=157 |issue=4 Pt 1 |pages=1063–72 |year=1998 |pmid=9563720 |doi=10.1164/ajrccm.157.4.9703022 |url=}}</ref><ref name="pmid21996929">{{cite journal |vauthors=Neghab M, Mohraz MH, Hassanzadeh J |title=Symptoms of respiratory disease and lung functional impairment associated with occupational inhalation exposure to carbon black dust |journal=J Occup Health |volume=53 |issue=6 |pages=432–8 |year=2011 |pmid=21996929 |doi= |url=}}</ref>
**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
|-
|-
|Coal Worker's Pneumoconiosis
|Asbestosis
|
|
|
|
|
|
* Lung cancer
* Mesothelioma
|
|
* Predilection to lower lobes
* Fine and coarse linear, peripheral, reticular opacities
|
|
|
|
|-
|Berylliosis 
|
|
|
|
|
|
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* 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 
|
|
|
|
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|
|
|-
|-
|Eosinophilic Pneumonia
| rowspan="3" |Eosinophilic Pneumonia
|Acute
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
|
|
|
|
|
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|-
|Loffler syndrome
|
|
|
|
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|
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|
|
|
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|
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|-
|Chronic
|
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|
|
|
|
|
|
|
|
|
|
|
|
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|-
| colspan="2" |Sarcodiosis
|
|
|
|
|
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|
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|-
|-
| colspan="2" |Pleural Effusion
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|-
| colspan="2" |Myasthenia gravis
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|-
| rowspan="2" |Neuromuscular disease
|Muscular dystrophy
|
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|
|
|
|
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|
|
|
|
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|
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|-
|ALS
|
|
|
|

Revision as of 17:44, 15 February 2018

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
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
  • 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
  • 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.
  • Abnormal ABG

[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
    • 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
Neuromuscular disease Muscular dystrophy
ALS
  1. du Bois RM (2006). "Evolving concepts in the early and accurate diagnosis of idiopathic pulmonary fibrosis". Clin. Chest Med. 27 (1 Suppl 1): S17–25, v–vi. doi:10.1016/j.ccm.2005.08.001. PMID 16545629.
  2. Gay SE, Kazerooni EA, Toews GB, Lynch JP, Gross BH, Cascade PN, Spizarny DL, Flint A, Schork MA, Whyte RI, Popovich J, Hyzy R, Martinez FJ (1998). "Idiopathic pulmonary fibrosis: predicting response to therapy and survival". Am. J. Respir. Crit. Care Med. 157 (4 Pt 1): 1063–72. doi:10.1164/ajrccm.157.4.9703022. PMID 9563720.
  3. Neghab M, Mohraz MH, Hassanzadeh J (2011). "Symptoms of respiratory disease and lung functional impairment associated with occupational inhalation exposure to carbon black dust". J Occup Health. 53 (6): 432–8. PMID 21996929.