Sandbox:Amd

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Differential diagnosis

Abbreviations: COPD= Chronic obstructive pulmonary disease,

Causes of cyanosis Disease Cyanosis Clinical manifestations/association Diagnosis Additional findings Symptoms Signs Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Respiratory Airway disorder Severe Croup ✔ − ✔ ✔ − − − Audible stridor at rest Lymphocytosis AP Neck X ray for soft tissues: Steeple sign Lateral neck X ray: Distended hypopharynx during inspiration Clinical diagnosis Croupy cough and stridor Intercostal, subcostal retractions Epiglottitis ✔ − ✔ ✔ − − − Stridor Leukocytosis with neutrophilia Blood cultures Throat culture in intubated patients Lateral neck X ray Thumbprint sign(swollen epiglottis) Laryngoscopy Sore Throat Dysphagia Odynophagia Muffled voice Foreign body aspiration ✔ ✔ ✔ ✔ − − Decreased breath sounds Wheezing Airway trauma ✔ + + ± − − Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings Parenchymal disorder Pulmonary embolism ✔ ✔ − ✔ − − − ABGs D-dimer CXR V/Q scan Spiral CT pulmonary angiogram Dyspnea Tachycardia Pleuretic chest pain Pneumonia ✔ ✔ ✔ − − − − ABGs Leukocytosis Pancytopenia CXR CT chest Bronchoscopy Shortness of breath Cough Asthma (Late) ✔ ✔ + ✔ − − − Cystic fibrosis ✔ ± ± − − − COPD (Emphysema) ✔ ± + Empyema ✔ ✔ ✔ − − Crackles Thoracentesis Chest X-ray Pleural opacity Localization of effusion Physical examination Crackles Egophony Increased tactile fremitus Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings Chest wall disorders Flail chest − ✔ − − − Pneumothorax ✔ ✔ − ✔ − − − Hemothorax ✔ ✔ ± − − Cardiovascular Congenital heart diseases Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings Atrioventricular canal defect ✔ ✔ + + Ebstein anomaly ✔ ✔ Hypoplastic left heart syndrome ✔ Pulmonary atresia ✔ Tetralogy of Fallot ✔ ✔ Pulmonic stenosis ✔ Total anomalous pulmonary venous drainage ✔ Transposition of the great vessels ✔ Truncus arteriosus ✔ Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings Heart failure ✔ ✔ + − + ✔ + Valvular heart disease ✔ + − − − − Myocardial infarction ✔ ✔ − ✔ − − − Hematologic Methemoglobinemia ✔ Polycythemia ✔ Central Nervous system Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings Coma ✔ Seizures ✔ Head trauma ✔ Breath holding spells ✔ Miscellaneous Shock ✔ Smoke inhalation ✔ + + + Toxic gases + + + + ± Cold exposure ✔ − − − − − − Drugs† − − − − −