Summary: Respi Lung Sounds Pathology

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• 1 RESPI DIFFERENTIAL DX AND TESTS

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• What investigations are appropriate for detecting infections like pneumonia or exacerbation of COPD?

  • Chest X-ray: Consolidation in pneumonia
  • O₂ saturation or ABG: Respiratory failure assessment
  • Sputum and blood culture: Causal infection
  • Respiratory function: COPD quantification
  • WCC, CRP: Inflammation degree

• What are the suggestive features on history and examination for acute bronchitis?

  • History:
    • Wheeze
    • Cough
    • Sputum
  • Examination:
    • Wheeze
    • Hyperinflation

• How is malignancy in the respiratory system assessed?

  • Chest X-ray
  • CT scan thorax + abdomen
  • Bronchoscopy (central)
  • CT-guided biopsy (peripheral)
  • Respiratory function

  Diagnostic values:
  

  • Masses identification
  • Staging extent
  • Pathology diagnosis
  • Radical therapies fitness

• Describe the features of pneumonia on history and examination.

  • History:
    • Pleuritic pain
    • Rusty sputum
    • Rigors
  • Examination:
    • If lobar, dull to percussion
    • Bronchial breathing

• What are the initial investigations for pulmonary fibrosis or interstitial lung disease?

  • Chest X-ray: Bi-basal reticular shadows
  • High-resolution CT thorax: Extent/type of disease
  • Respiratory function: Quantification, restrictive patterns
  • Autoantibodies: Connective tissue disease identification

• What are the suggestive features of malignancy related to respiratory problems?

  • History:
    • Insidious onset
    • Weight loss
    • Persisting pain or cough
  • Examination:
    • Cervical lymphadenopathy
    • Clubbing
    • Signs of lobar/lung collapse ± effusion

• How is pleural effusion initially investigated?

  • Chest X-ray
  • Ultrasound-guided aspiration

  Diagnostic values:
  

  • Dense basal fluid pool
  • Infection culture
  • Empyema pH
  • Infection low glucose
  • Malignancy cytology
  • Transudate/exudate protein
  • Underyling tumor identification

• Explain the features on history and examination of pulmonary fibrosis.

  • History:
    • Progressive dyspnoea
  • Examination:
    • Tachypnoea
    • Inspiratory fine crackles at bases
    • Cyanosis

• What diagnostic tools are used for pulmonary embolism?

  • d-Dimer: Negative if no embolism
  • CT pulmonary angiogram: Emboli detection
  • Echocardiogram: Right ventricular strain
  • O₂ saturation or ABG: Respiratory failure assessment

• What are the suggestive features on history for pleural effusion?

  • History:
    • Progressive dyspnoea
  • Examination:
    • Unilateral basal dullness
    • Reduced breath sounds