Sandbox:Vindhya

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_NO TOC_ Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Hyperventilation

Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Chest pain Dyspnea Fever Palpitations Cyanosis Tachypnea JVD Peripheral edema Auscultation ABGs Lab findings Imaging PFT Gold standard
Pulmonary system Pneumothorax + + + + + + _ _
  • Decreased breath sounds
X- ray -
  • Mediastinal shift
  • Deep sulcus sign
  • Hydropneumothorax
  • CT-scan- Bullae
CT-scan
  • Hypoxia,
  • Hypercapnia
  • Hyperesonance to percussion,
  • Vocal resonance
  • Tactile fremitus decreased
Pulmonary embolism + + + + + +
Pneumonia + + + + + + - -
  • Bronchial breath sounds
  • Crepitations
  • Bronchophony
  • Egophony
  • Whispering pectoroloqy
  • CBC
  • Blood culture
  • Mantoux test
  • Serology (mycoplasma, viruses)
  • Sputum: Gram stain and culture
  • CXR- Lobar consolidation, Air bronchogram;
  • Atypical pneumonia: Diffuse interstitial infiltrates
Exacerbation of asthma/COPD - + - + + + - -
  • Decreased breath sounds
  • Wheezing
  • Coarse crackles
  • Increased PaCo2
  • Decreased PaO2
  • CBC- Increased hematocrit from chronic hypoxia
  • Sputum evaluation, BNP( to rule out heart failure)
  • X- ray:
  • Hyperinflated lungs
  • Flattening of the diaphragm
  • Narrow heart shadow
  • Cardiomegaly
  • Increased TLC
  • Increased RV
  • Decreased Vital capacity
  • Decreased DLco ( Emphysema)
  • Normal DLco ( Chronic bronchitis)
  • HRCT ( High resolution computed tomography of the lung)
  • Productive cough
  • Exercise intolerance
  • Altered mental status
  • Cor-pulmonale
  • Hyperresonance on percussion
Interstitial lung disease + + -/+ + + + -/+ -
  • Fine crackles
  • Loud P2
  • Increased A-a gradient
  • Decreased PaO2
  • Increased PaCo2
  • Chest X-ray- Reticular infiltrates
  • Honey combing
  • FEV1 decreased
  • FVC decreased
  • TLC decreased
  • RV decreased
  • DLco decreased
  • FEV1/FVC normal
  • HRCT -more accurate than chest xray
  • Most accurate test is lung biopsy
  • Physical examination shows clubbing
  • Decreased pulmonary compliance
Intrapulmonary shunt
Upper airway obstruction -/+ + - -/+ -/+ + -/+ - Inspiratory stridor
  • Increased PaCo2
  • Decreased PaO2
  • Plain radiograph of the neck
  • Steeple sign (Croup in pediatric population)
  • CT
  • MRI
Decreased vital capacity
  • HRCT
  • Bronchoscopy
  • Hoarseness
  • Accessory muscle use during respiration
  • Chest retractions
High altitude sickness - + +/- + +/- + - +
  • Crackles
  • Respiratory alkalosis
  • CBC
  • EKG- Right sided heart strain

CXR- Bilateral patchy infiltrates

Cardiovascular system Acute coronary syndrome
Heart failure
Dysrhythmias
Shock
Metabolic/Systemic disorders Diabetic ketoacidosis
Hypocalcemia
Hypoglycemia
Endocrine system Hyperthyroidism
Pheochromocytoma
CNS Central nervous system tumor
Anxiety/panic attacks
Others Pregnancy
Hepatic failure
Sepsis