Cyanosis differential diagnosis: Difference between revisions

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Revision as of 20:51, 9 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Differential diagnosis

Abbreviations: AP= Anteroposterior, CXR= Chest X-ray, CT= Computed tomography, ABG= Arterial blood gas, V/Q= Ventilation/perfusion scan , EKG= Electrocardiogram, COPD= Chronic obstructive pulmonary disease, BNP= Brain natriuretic peptide, DVT= Deep vein thrombosis, HRCT= High Resolution CT, IgE= Immunoglobulin E

					Symptoms			Physical examination			Lab Findings				Imaging
Diseases			Cyanosis		Clinical manifestations						Para-clinical findings							Gold standard	Additional findings
					Symptoms			Physical examination			Para-clinical findings
			Peripheral	Central	Dyspnea	Fever	Chest pain	Clubbing	Peripheral edema	Auscultation	CBC	ABG	Electrolytes	Other	X-ray	CT scan	Other
Pulmonary diseases	Airway disorder	Severe croup^[1]	+	-	+	+/-	-	-	-	Stridor	Lymphocytosis	Normal	Normal	-	Steeple sign	Normal	Distended hypopharynx during inspiration	Clinical findings	Intercostal and subcostal retraction, Barking cough
		Epiglottitis^[2]	+	-	+	+	-	-	-	Stridor	Leukocytosis with neutrophilia	Normal	Normal	-	Thumb sign	Normal	-	Laryngoscopy	Muffled voice, Drooling
		Foreign body aspiration^[3]	+	-	+	-	+/-	-	-	Decreased breath sounds, Wheezing	Normal	Normal	Normal	-	Hyperinflation, Atelectasis, Objects	Foreign body entrapment with edema or granulation tissue	-	Bronchoscopy	Mediastinitis
		Bacterial tracheitis^[4]	+	-	+	+	+	-	-	Inspiratory stridor	Leukocytosis	Normal	Normal	Blood culture, Gram stain	Irregular tracheal margin	Normal	Steeple sign (confusing)	Laryngotracheobronchoscopy	Brassy cough, Hoarseness
		Sleep apnea^[5]	-	+	+	-	-	-	-	Normal	Polycythemia	↓O2, ↑CO2	Normal	-	Normal	Normal	Polysomnography	Polysomnography	Nightmares, Snoring
		Chronic bronchitis^[6]	-	+	+	+/-	+/-	+	-	Rales, crackles, Wheeze	Leukocytosis	↓O2, ↑CO2, Respiratory acidosis	Hypokalemia, Hypernatremia	Gram stain of sputum	Elongated heart, Flattened diaphragms, Prominent hilar vasculature	Bronchial wall thickening with increased bronchovascular markings	-	HRCT	Productive cough, Chest tightness
		Atelectasis^[7]	-	+	+	-	+	-	-	Localized diminished breath sounds, Wheeze	Leukocytosis	↓O2, ↑CO2, Respiratory acidosis	Normal	-	Localized increased opacity, Deviation toward the atelectasis	Local crowding of pulmonary vessels and bronchi	MRI for distinguishing obstructive from non-obstructive	HRCT	Cough. Shallow breathing
	Parenchymal disorder	Alveolitis^[8]	+/-	+	+	+	+	+/-	-	Wheeze, Crackles	Leukocytosis, Eosinophilia	↓O2, ↑CO2	Normal	↑ESR, ↑CRP	Scattered opacities, Fine reticulation	Homogeneous ground-glass opacity	-	HRCT PLUS Clinical findings	Malaise, Chills, Headache
		Pneumonia^[9]	-	+	+	+	+	+/-	-	Rales, Crackles, Wheeze, Pleural friction rub	Leukocytosis with neutrophilia	Normal	Hyponatremia	-	Entire lobe consolidated, Air bronchograms	Focal ground-glass opacity	-	HRCT	Tachycardia, Bradycardia (Legionella)
		Asthma (Late)^[10]	-	+	+	-	+/-	+/-	-	End expiratory wheeze	Eosinophilia	↓O2, ↑CO2	Normal	↑ IgE	Atelectasis	Allergic bronchopulmonary aspergillosis, Bronchiectasis	-	Spirometry before and after bronchodilator	Triad of asthma, nasal polyps, and rash is indicative of aspirin sensitivity.
		Cystic fibrosis^[11]	+	-		+/-	+/-	+	-	Wheeze, Crackles	Normal	↓O2, ↑CO2	Increased sweat chloride	Sweat chloride test	Hyperinflation, Nodules	Peribronchial thickening, Bronchiectasis	-	Sweat chloride test	Absent vas deferens
		COPD (Severe emphysema)^[12]	+	-	+	+/-	+	+/-	+/-	Reduced breath sounds, Wheeze, Inspiratory crackles	Polycythemia	↓O2, ↑CO2	Normal	Alpha 1-antitrypsin test	Elongated heart, Flattened diaphragms, Prominent hilar vasculature	Bullae	-	HRCT	Pulmonary hypertension, Right heart failure
		Tuberculosis^[13]	-	+	+	+	+	+/-	-	Reduced breath sounds, Wheeze, Inspiratory crackles	Leukocytosis, ↑Lymphocyte	↓O2, ↑CO2	Hyponatremia, Hyperkalemia, Hypochloremia	PPD, interferon-gamma release assay (IGRA)	dense, homogeneous parenchymal consolidation	Nodules with low-density centers and rim enhancement	Fluorodeoxyglucose positron emission tomography/CT (FDG PET/CT)	Sputum culture, QuantiFERON-TB Gold (QFT)	Loss of appetite, Night sweats
		Pulmonary fibrosis	-	+	+	-	+	+	-
		Pneumoconiosis	-	+	+	-	+/-	+/-	-
		Lung cancer	-	+	+	-	+/-	+	-
		Acute respiratory distress syndrome	-	+	+	+/-	+	-	-
	Pulmonary vascular disorders	Massive pulmonary embolism^[14]	+	-	+	+/-	+	-	+/-	Reduced breath sounds, Crackles, Loud P2	Leukocytosis	↓O2, ↑CO2, Respiratory acidosis	Normal	D-dimer, BNP	Fleischner sign, Hampton hump, Westermark sign, Pleural effusion	Filling defects in the pulmonary vasculature	Spiral CT pulmonary angiogram	Spiral CT pulmonary angiogram	Tachycardia, Shock, Pulmonary hypertension
		Pulmonary arterio-venous malformation^[15]^[16]^[17]	-	+	+	-	+	+	-	Pulmonary bruit	Normal	↓O2, ↑CO2, Respiratory acidosis	Normal	-	One or more rounded or multilobular opacities	Connecting vessel in hilum	Magnetic resonance angiography, Echocardiography	Contrast enhanced magnetic resonance angiography	Cerebral arteriovenous malformation
		Pulmonary hypertension		+
Chest wall disorders		Flail chest^[18]	+	-	+	-	+	-	-	Normal	Normal	↓O2, ↑CO2	Normal	-	≥3 adjacent ribs with segmental fractures, >5 adjacent rib fractures	Normal	-	CXR	Bruises over chest
Chest wall disorders		Pneumothorax^[19]	+	-	+	-	+	-	-	Diminished breath sounds	Normal	↓O2, ↑CO2	Normal	-	No lung marking on one side, Collapsed lung	Loculated air in thoracic cavity	M-mode ultrasonography	Chest CT scan	Tachypnea
Disease			Peripheral	Central	Dyspnea	Fever	Chest pain	Clubbing	Peripheral edema	Auscultation	CBC	ABG	Electrolytes	Other	X-ray	CT scan	Other	Gold standard	Additional findings
Cardiac diseases	Congenital disorders	Atrioventricular canal defect^[20]	+/-	+	+	-	+/-	+/-	-	Wheezing,Holosystolic or systolic ejection murmur	Normal	Normal	Normal	Pulse oximetry	Cardiomegaly, Increased pulmonary vascular markings	Normal	Echocardiography, MRI	Echocardiography	Tachypnea, Lack of appetite, Pale skin color, Excessive sweating
		Ebstein anomaly^[21]	-	+	+/-	-	+/-	-	-	Loud S1	Normal	Normal	Normal	Pulse oximetry	Cardiomegaly, "Box shape" heart	Apical displacement of the septal and posterior leaflets of the tricuspid valve	"Atrialisation" of the right ventricle in MRI, Tricuspid regurgitation in echocardiography	Echocardiography	Fatigue, Palpitations
		Tetralogy of Fallot^[22]	-	+	+/-	-	+/-	-	-	Harsh systolic murmur	Normal	Normal	Normal	Pulse oximetry	"Boot-shaped" heart with an upturned cardiac apex	Aortopulmonary collateral vessels	Peripheral pulmonary stenosis and atresia in echocardiography	Echocardiography	Fainting, Palpitation
		Pulmonic stenosis^[23]	-	+	+	-	+	+/-	-	Crescendo-decrescendo ejection murmur	Schistocyte	↓O2	Normal	Pulse oximetry	Right ventricular hypertrophy, Dilated main pulmonary artery	Stenotic segment, Post stenotic dilatation	Severity of the stenosis by velocity encoded phase contrast (VEC) cine sequences	Echocardiography	Fainting, Palpitation
		Total anomalous pulmonary venous connection^[24]	-	+	+	-	+/-	+/-	-	Systolic murmur over the pulmonary area	Normal	↓O2	Normal	Pulse oximetry	Snowman sign	Anomalous venous return	Blind ended left atrium with no connecting veins in echocardiography	Echocardiography	Pounding heart, Weak pulse, Extreme sleepiness
		Transposition of the great vessels^[25]	-	+	+	-	+/-	+/-	-	Diastolic and Systolic murmur	Normal	↓O2	Normal	Pulse oximetry	Cardiomegaly with narrow superior mediastinum (egg on a string sign)	Abnormal great vessel anatomy	Flow dynamics on Steady-state free precession (SSFP) MRI	Echocardiography	Lack of appetite, Poor weight gain
		Truncus arteriosus^[26]	-	+	+/-	-	+/-	+/-	-	Holosystolic or ejection type murmur	Normal	↓O2	Normal	Pulse oximetry	Moderate cardiomegaly, pulmonary plethora, Widened mediastinum	Single cardiac trunk	Anomalous anatomy in MRI	Echocardiography	Fatigue, Sweating, Pale or cool skin
		Patent ductus arteriosus	-	+
	Acquired disorders	Heart failure^[27]	+	-	+	+/-	+	-	+	Coarse crackles, S3	Anemia	↓O2, ↑CO2	Hyponatremia, Hypokalemia, Hypomagnesemia	Elevated BNP	Pleural effusion, Cardiomegaly Kerley B lines	-	Radioisotope scan	Echocardiography	Generalized edema, Hepatomegaly
		Valvular heart disease^[28]	+	-	+	-	-	-	+	Murmurs	Schistocyte	Normal	Normal	Hyperthyroidism	Valve calcification	-	Valvular dysfunction in echocardiography	Echocardiography	Syncope, Palpitation
		Myocardial infarction^[29]	-	+	+	+/-	+	-	-	S3 and S4	Normal	Normal	Hyponatremia, Hypokalemia	Elevated troponin I and CKMB	Rolling out other causes	Coronary luminal narrowing in CT perfusion scan	Wall motion abnormality in echocardiography	Cardiac troponin I	Dizziness, Fatigue, Lightheadedness, Cold sweat
		Cardiogenic shock^[30]	+/-	+	+	-	-	-	+	Muffled heart sound	Anemia	↓O2, ↑CO2	Hyperkalemia	↓PaO2 in pulse oximetry	Normal	Normal	Echocardiography	Clinical findings	Tachypnea, Palpitation, Hypotension, Weak pulse
		Cardiomyopathy	-	+
		Heart tumors	-	+
		Mitral Stenosis	-	+
Vascular disease	Arterial disorders	Acrocyanosis	+	-
		Arterial embolism	+	-
		Raynaud's Phenomenon	+	-
	Venous disorders	Superior vena cava obstruction	+	-
	Venous disorders	Venous stasis	+	-
Disease			Peripheral	Central	Dyspnea	Fever	Chest pain	Clubbing	Peripheral edema	Auscultation	CBC	ABG	Electrolytes	Other	X-ray	CT scan	Other	Gold standard	Additional findings
Hematologic diseases		Methemoglobinemia^[31]	-	+	+	+/-	+	-	-	Wheezing	Anemia, Methemoglobinemia	Normal PaO2, ↑SaO2, "Saturation gap"	Normal	↓SaO2 in pulse oximetry	Normal	Normal	Echocardiography for ruling out other causes	Co-oximetry, ABG paired with pulse oximetry. Serum methemoglobin levels	Headache, Altered mental status, Delirium, Seizure, Coma
Hematologic diseases		Polycythemia^[32]	+	+	+	+/-	+/-	+	-	Normal	↑RBC, ↑WBC, ↑HGB, ↑Plt	↓O2	Hyperkalemia	↑Leukocyte alkaline phosphatase, ↑Ferritin, ↑Erythropoietin	AVM, COPD, pulmonary hypertension	Normal	Abdominal ultrasound or renal vascular studies for ruling out renal artery stenosis	RBC mass (RCM) and plasma volume measurement	Itchiness, Headache. Dizziness. Blurred vision
Neurological disease		Breath-holding spells^[33]	-	+	+	-	+/-	-	-	Wheezing	Hypochromic microcytic anemia	↓O2	Hypocalcemia, Hypokalemia	Iron deficiency	Ruling out foreign body aspiration	Normal	EEG monitoring	Clinical findings	Fainting, Twitching muscles, Seizure
		Seizure^[34]	-	+	+	+/-	-	-	-	Normal	Normal	↓O2, ↑CO2	Hyponatremia, Hypo/Hypercalcemia	↑CPK, ↑LDH,	Normal	Normal	EEG	EEG	Fainting, Tonic-clonic movements
		Coma^[35]	-	+	-	-	-	-	+/-	Wheezing	Normal	↓O2, ↑CO2	Normal	-	Underlying disease	Underlying disease	-	Glasgow Coma Scale (GCS)	Depressed brainstem reflexes, Agonal breathing
		Head trauma^[36]	-	+	+	-	-	-	-	Normal	Normal	↓O2, ↑CO2	Normal	-	Skull fracture	Intracranial hemorrhage	MRI	CT scan	Nausea, Hypertension, Bradycardia,Tachypnea
Miscellaneous		High altitude exposure	+/-	+
		Septic shock^[37]	+	-	+	+	+/-	-	-	Rales, crackles, Wheeze, Pleural friction rub	Leukocytosis with neutrophilia	↓O2, ↑CO2, Metabolic acidosis	Hyperkalemia	↑ESR, ↑CRP	Consolidation	Pulmonary infiltration	Echocardiography	Blood culture	Chills, Hypothermia, Loss of consciousness
		Smoke inhalation^[38]	+/-	+	+	-	+	-	-	Wheezing	Anemia, Carboxyhemoglobin	↓O2, ↑CO2, Respiratory acidosis	Normal	CO-oximetry	Diffuse opacities	Pulmonary infiltration	Pulmonary function testing	Bronchoscopy	Cough, Hoarseness, Hemoptysis, Headache, Fainting
		Cold exposure^[39]	+	-	+/-	-	-	-	-	Normal	Leukopenia, ↑RBC	↓O2, ↑CO2, Metabolic acidosis	Hypokalemia, Hypocalcemia	Hyperglycemia, ↑CK	Normal	Normal	-	Clinical findings	Mild (32-35°C): Confusion, tachycardia, and increased ↑shivering. Moderate (28-32°C): Lethargy, bradycardia, arrhythmia and ↓shivering. Severe (<28°C) Coma, hypotension, arrhythmia, pulmonary edema, and rigidity.

References

↑ Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.
↑ Abdallah C (2012). "Acute epiglottitis: Trends, diagnosis and management". Saudi J Anaesth. 6 (3): 279–81. doi:10.4103/1658-354X.101222. PMC 3498669. PMID 23162404.
↑ Qureshi A, Behzadi A (2008). "Foreign-body aspiration in an adult". Can J Surg. 51 (3): E69–70. PMC 2496600. PMID 18682760.
↑ Liston SL, Gehrz RC, Siegel LG, Tilelli J (August 1983). "Bacterial tracheitis". Am. J. Dis. Child. 137 (8): 764–7. PMID 6869336.
↑ Spicuzza L, Caruso D, Di Maria G (2015). "Obstructive sleep apnoea syndrome and its management". Ther Adv Chronic Dis. 6 (5): 273–85. doi:10.1177/2040622315590318. PMC 4549693. PMID 26336596.
↑ Kim V, Criner GJ (2013). "Chronic bronchitis and chronic obstructive pulmonary disease". Am J Respir Crit Care Med. 187 (3): 228–37. doi:10.1164/rccm.201210-1843CI. PMC 4951627. PMID 23204254.
↑ Peroni DG, Boner AL (September 2000). "Atelectasis: mechanisms, diagnosis and management". Paediatr Respir Rev. 1 (3): 274–8. doi:10.1053/prrv.2000.0059. PMID 12531090.
↑ Lee JS, Im JG, Ahn JM, Kim YM, Han MC (August 1992). "Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high-resolution CT". Radiology. 184 (2): 451–4. doi:10.1148/radiology.184.2.1620846. PMID 1620846.
↑ Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J (2014). "Management of community-acquired pneumonia in older adults". Ther Adv Infect Dis. 2 (1): 3–16. doi:10.1177/2049936113518041. PMC 4072047. PMID 25165554.
↑ Litonjua AA (June 2009). "Childhood asthma may be a consequence of vitamin D deficiency". Curr Opin Allergy Clin Immunol. 9 (3): 202–7. doi:10.1097/ACI.0b013e32832b36cd. PMID 19365260.
↑ "Cystic fibrosis - Genetics Home Reference".
↑ Qureshi H, Sharafkhaneh A, Hanania NA (2014). "Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications". Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.
↑ Olalekan, Adebimpe Wasiu; Oluwaseun, Faremi Ayodeji; Oladele, Hassan Abdul-Wasiu; Akeem, Adeyemi Damilare (2015). "Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria". Alexandria Journal of Medicine. 51 (3): 255–260. doi:10.1016/j.ajme.2014.10.003. ISSN 2090-5068.
↑ Bĕlohlávek J, Dytrych V, Linhart A (2013). "Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism". Exp Clin Cardiol. 18 (2): 129–38. PMC 3718593. PMID 23940438.
↑ Khurshid I, Downie GH (2002). "Pulmonary arteriovenous malformation". Postgrad Med J. 78 (918): 191–7. PMC 1742331. PMID 11930021.
↑ Doshi HM, Robinson S, Chalhoub T, Jack S, Denison A, Gibson G (2009). "Massive spontaneous hemothorax during the immediate postpartum period". Tex Heart Inst J. 36 (3): 247–9. PMC 2696501. PMID 19568398.
↑ Chanatry BJ (1992). "Acute hemothorax owing to pulmonary arteriovenous malformation in pregnancy". Anesth. Analg. 74 (4): 613–5. PMID 1554132.
↑ Pettiford BL, Luketich JD, Landreneau RJ (February 2007). "The management of flail chest". Thorac Surg Clin. 17 (1): 25–33. doi:10.1016/j.thorsurg.2007.02.005. PMID 17650694.
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[Cherry20082-1] Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.

[pmid23162404-2] Abdallah C (2012). "Acute epiglottitis: Trends, diagnosis and management". Saudi J Anaesth. 6 (3): 279–81. doi:10.4103/1658-354X.101222. PMC 3498669. PMID 23162404.

[pmid18682760-3] Qureshi A, Behzadi A (2008). "Foreign-body aspiration in an adult". Can J Surg. 51 (3): E69–70. PMC 2496600. PMID 18682760.

[pmid6869336-4] Liston SL, Gehrz RC, Siegel LG, Tilelli J (August 1983). "Bacterial tracheitis". Am. J. Dis. Child. 137 (8): 764–7. PMID 6869336.

[pmid26336596-5] Spicuzza L, Caruso D, Di Maria G (2015). "Obstructive sleep apnoea syndrome and its management". Ther Adv Chronic Dis. 6 (5): 273–85. doi:10.1177/2040622315590318. PMC 4549693. PMID 26336596.

[pmid23204254-6] Kim V, Criner GJ (2013). "Chronic bronchitis and chronic obstructive pulmonary disease". Am J Respir Crit Care Med. 187 (3): 228–37. doi:10.1164/rccm.201210-1843CI. PMC 4951627. PMID 23204254.

[pmid12531090-7] Peroni DG, Boner AL (September 2000). "Atelectasis: mechanisms, diagnosis and management". Paediatr Respir Rev. 1 (3): 274–8. doi:10.1053/prrv.2000.0059. PMID 12531090.

[pmid1620846-8] Lee JS, Im JG, Ahn JM, Kim YM, Han MC (August 1992). "Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high-resolution CT". Radiology. 184 (2): 451–4. doi:10.1148/radiology.184.2.1620846. PMID 1620846.

[pmid25165554-9] Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J (2014). "Management of community-acquired pneumonia in older adults". Ther Adv Infect Dis. 2 (1): 3–16. doi:10.1177/2049936113518041. PMC 4072047. PMID 25165554.

[pmid19365260-10] Litonjua AA (June 2009). "Childhood asthma may be a consequence of vitamin D deficiency". Curr Opin Allergy Clin Immunol. 9 (3): 202–7. doi:10.1097/ACI.0b013e32832b36cd. PMID 19365260.

[urlCystic_fibrosis_-_Genetics_Home_Reference-11] "Cystic fibrosis - Genetics Home Reference".

[pmid25177479-12] Qureshi H, Sharafkhaneh A, Hanania NA (2014). "Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications". Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.

[OlalekanOluwaseun2015-13] Olalekan, Adebimpe Wasiu; Oluwaseun, Faremi Ayodeji; Oladele, Hassan Abdul-Wasiu; Akeem, Adeyemi Damilare (2015). "Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria". Alexandria Journal of Medicine. 51 (3): 255–260. doi:10.1016/j.ajme.2014.10.003. ISSN 2090-5068.

[pmid23940438-14] Bĕlohlávek J, Dytrych V, Linhart A (2013). "Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism". Exp Clin Cardiol. 18 (2): 129–38. PMC 3718593. PMID 23940438.

[pmid119300212-15] Khurshid I, Downie GH (2002). "Pulmonary arteriovenous malformation". Postgrad Med J. 78 (918): 191–7. PMC 1742331. PMID 11930021.

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@@ Line 5: / Line 5: @@
 {{CMG}}
 ==Overview==
-== Differential Diagnosis of Central Cyanosis ==
+== Differential diagnosis ==
-* [[Abnormal hemoglobin]]
-* [[Acute respiratory distress syndrome]]
-* [[Alveolitis]]
-* [[Atelectasis]]
-* [[Atrial septal defect]]
-* [[Bronchiectasis]]
-* Central or peripheral respiratory paralysis
-* Chronic [[bronchitis]]
-* [[Congenital heart disease]]
-* Decreased respiration with oversedation
-* [[Double outlet right ventricle]]
-* [[Emphysema]] <br>
-* Foreign-body [[aspiration]]
-* [[High altitude exposure]]
-* [[Hypersensitivity pneumonitis]]
-* [[Intoxication]]
-* Intrapulmonary arteriovenous aneurysms
-* [[Lung cancer]]
-* [[Mediastinitis]]
-* [[Patent ductus arteriosus]]
-* [[Pickwickian syndrome]]
-* [[Pleural Effusions]]
-* [[Pneumoconiosis]]
-* [[Poliomyelitis]]
-* [[Polyneuropathy]]
-* [[Primary alveolar hypoventilation]]
-* Pulmonary arteriovenous fistulas
-* [[Pulmonary edema]]
-* [[Pulmonary embolism]]
-* [[Pulmonary fibrosis]]
-* [[Pulmonary hypertension]]
-* Severe [[chronic obstructive pulmonary disease]] ([[COPD]]) or [[asthma]]
-* Severe [[pneumonia]]
-* Single ventricle
-* [[Sleep apnea]]
-* Tension [[pneumothorax]]
-* [[Tetralogy of Fallot]]
-* Toxins/poisons <br>
-* [[Transposition of the great vessels]]
-* [[Tuberculosis]]
-* [[Ventricular septal defect]]
-== Differential Diagnosis of Peripheral Cyanosis ==
-* [[Ddx:Acrocyanosis|Acrocyanosis]]
-* Arterial [[embolism]]
-* [[Arrhythmia]]
-* [[Cardiomyopathy]]
-* [[Cold exposure]]
-* [[Congenital Heart Disease]]
-* [[Congestive Heart Failure]]
-* [[Endomyocardial fibrosis]]
-* [[Heart tumors]]
-* [[Hypertensive heart disease]]
-* [[Mitral Stenosis]]
-* [[Pericardial effusion]]
-* [[Polycythemia vera]]
-* [[Raynaud's Phenomenon]]
-* [[Shock]]
-* [[Superior vena cava obstruction]]
-* [[Valvular disease]]
-* Venous hypertension
-* [[Venous stasis]]
-==Differential diagnosis==
 <span style="font-size:85%">'''Abbreviations:'''
 AP= Anteroposterior, CXR= [[Chest X-ray]], CT= [[Computed tomography]], ABG= [[Arterial blood gas]], V/Q= [[Ventilation/perfusion scan]] , EKG= [[Electrocardiogram]], COPD= [[Chronic obstructive pulmonary disease]], BNP= [[Brain natriuretic peptide]], DVT= [[Deep vein thrombosis]], HRCT= [[High Resolution CT]], IgE= [[Immunoglobulin E]]</span>
@@ Line 106: / Line 42: @@
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
 |-
-! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary disease|Pulmonary diseases]]
+! rowspan="20" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary disease|Pulmonary diseases]]
-! rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Airway]] disorder
+! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Airway]] disorder
 | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Severe [[croup]]<ref name="Cherry20082">{{cite journal|last1=Cherry|first1=James D.|title=Croup|journal=New England Journal of Medicine|volume=358|issue=4|year=2008|pages=384–391|issn=0028-4793|doi=10.1056/NEJMcp072022}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 122: / Line 58: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Steeple sign]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Distended [[hypopharynx]] during [[inspiration]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Clinical findings
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Intercostal]] and [[subcostal]] [[retraction]], [[Barking cough]]
 |-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Epiglottitis]]
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Epiglottitis]]<ref name="pmid23162404">{{cite journal| author=Abdallah C| title=Acute epiglottitis: Trends, diagnosis and management. | journal=Saudi J Anaesth | year= 2012 | volume= 6 | issue= 3 | pages= 279-81 | pmid=23162404 | doi=10.4103/1658-354X.101222 | pmc=3498669 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23162404  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 141: / Line 77: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Thumbprint sign|Thumb sign]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Laryngoscopy]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Muffled voice, [[Drooling]]
 |-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Foreign body aspiration]]
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Foreign body aspiration]]<ref name="pmid18682760">{{cite journal| author=Qureshi A, Behzadi A| title=Foreign-body aspiration in an adult. | journal=Can J Surg | year= 2008 | volume= 51 | issue= 3 | pages= E69-70 | pmid=18682760 | doi= | pmc=2496600 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18682760  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 165: / Line 101: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Mediastinitis]]
 |-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Bacterial tracheitis]]
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Bacterial tracheitis]]<ref name="pmid6869336">{{cite journal |vauthors=Liston SL, Gehrz RC, Siegel LG, Tilelli J |title=Bacterial tracheitis |journal=Am. J. Dis. Child. |volume=137 |issue=8 |pages=764–7 |date=August 1983 |pmid=6869336 |doi= |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 179: / Line 115: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Blood cultures|Blood culture]], [[Gram stain]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Irregular [[Tracheal disease|tracheal]] margin
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Steeple sign]] (confusing)
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bronchoscopy|Laryngotracheobronchoscopy]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Brassy [[cough]], [[Hoarseness]]
 |-
-! rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Parenchymal lung disease|Parenchymal]]
+![[Sleep apnea]]<ref name="pmid26336596">{{cite journal| author=Spicuzza L, Caruso D, Di Maria G| title=Obstructive sleep apnoea syndrome and its management. | journal=Ther Adv Chronic Dis | year= 2015 | volume= 6 | issue= 5 | pages= 273-85 | pmid=26336596 | doi=10.1177/2040622315590318 | pmc=4549693 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26336596  }}</ref>
+| -
+| +
+| +
+| -
+| -
+| -
+| -
+|Normal
+|[[Polycythemia]]
+|↓[[Oxygen|O2]], ↑[[CO2]]
+|Normal
+| -
+|Normal
+|Normal
+![[Polysomnography]]
+![[Polysomnography|'''Polysomnography''']]
+![[Nightmares]], [[Snoring]]
+|-
+!Chronic [[bronchitis]]<ref name="pmid23204254">{{cite journal| author=Kim V, Criner GJ| title=Chronic bronchitis and chronic obstructive pulmonary disease. | journal=Am J Respir Crit Care Med | year= 2013 | volume= 187 | issue= 3 | pages= 228-37 | pmid=23204254 | doi=10.1164/rccm.201210-1843CI | pmc=4951627 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23204254  }}</ref>
+| -
+| +
+| +
+| +/-
+| +/-
+| +
+| -
+|[[Rales]], [[crackles]], [[Wheeze]]
+|[[Leukocytosis]]
+|↓[[Oxygen|O2]], ↑[[CO2]], [[Respiratory acidosis]]
+![[Hypokalemia]], [[Hypernatremia]]
+![[Gram stain]] of [[sputum]]
+|Elongated [[heart]], Flattened [[Diaphragm|diaphragms]], Prominent [[hilar]] [[vasculature]]
+![[Bronchial]] wall thickening with increased bronchovascular markings
+| -
+|[[High Resolution CT|HRCT]]
+![[Productive cough]], [[Chest tightness]]
+|-
+![[Atelectasis]]<ref name="pmid12531090">{{cite journal |vauthors=Peroni DG, Boner AL |title=Atelectasis: mechanisms, diagnosis and management |journal=Paediatr Respir Rev |volume=1 |issue=3 |pages=274–8 |date=September 2000 |pmid=12531090 |doi=10.1053/prrv.2000.0059 |url=}}</ref>
+| -
+| +
+| +
+| -
+| +
+| -
+| -
+|Localized diminished [[breath sounds]], [[Wheeze]]
+|[[Leukocytosis]]
+|↓[[Oxygen|O2]], ↑[[CO2]], [[Respiratory acidosis]]
+|Normal
+| -
+!Localized increased [[opacity]],
+Deviation ''toward'' the [[atelectasis]]
+!Local crowding of [[pulmonary vessels]] and [[bronchi]]
+![[MRI]] for distinguishing obstructive from non-obstructive
+|[[High Resolution CT|HRCT]]
+![[Cough]]. [[Shallow breathing]]
+|-
+! rowspan="10" |[[Parenchymal lung disease|Parenchymal]]
 [[Parenchymal lung disease|disorder]]
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumonia]]
+![[Alveolitis]]<ref name="pmid1620846">{{cite journal |vauthors=Lee JS, Im JG, Ahn JM, Kim YM, Han MC |title=Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high-resolution CT |journal=Radiology |volume=184 |issue=2 |pages=451–4 |date=August 1992 |pmid=1620846 |doi=10.1148/radiology.184.2.1620846 |url=}}</ref>
+| +/-
+| +
+| +
+| +
+| +
+| +/-
+| -
+![[Wheeze]], [[Crackles]]
+|[[Leukocytosis]], [[Eosinophilia]]
+|↓[[Oxygen|O2]], ↑[[CO2]]
+|Normal
+|↑[[ESR]], ↑[[CRP]]
+!Scattered [[Opacity|opacities]], Fine reticulation
+!Homogeneous [[Ground glass opacification on CT|ground-glass opacity]]
+| -
+|[[High Resolution CT|HRCT]] PLUS [[Physical examination|Clinical findings]]
+![[Malaise]], [[Chills]], [[Headache]]
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumonia]]<ref name="pmid25165554">{{cite journal| author=Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J| title=Management of community-acquired pneumonia in older adults. | journal=Ther Adv Infect Dis | year= 2014 | volume= 2 | issue= 1 | pages= 3-16 | pmid=25165554 | doi=10.1177/2049936113518041 | pmc=4072047 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25165554  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 194: / Line 208: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Rales]], [[crackles]], [[Wheeze]], [[Pleural friction rub]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Rales]], [[Crackles]], [[Wheeze]], [[Pleural friction rub]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]], [[Pancytopenia]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]] with [[neutrophilia]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hyponatremia]]
@@ Line 205: / Line 219: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachycardia]], [[Bradycardia]] ([[Legionella]])
 |-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Asthma]] (Late)
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Asthma]] (Late)<ref name="pmid19365260">{{cite journal |vauthors=Litonjua AA |title=Childhood asthma may be a consequence of vitamin D deficiency |journal=Curr Opin Allergy Clin Immunol |volume=9 |issue=3 |pages=202–7 |date=June 2009 |pmid=19365260 |doi=10.1097/ACI.0b013e32832b36cd |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 224: / Line 238: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Triad of [[asthma]], [[nasal polyps]], and [[rash]] is indicative of [[Aspirin desensitization|aspirin sensitivity]].
 |-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cystic fibrosis]]
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cystic fibrosis]]<ref name="urlCystic fibrosis - Genetics Home Reference">{{cite web |url=https://ghr.nlm.nih.gov/condition/cystic-fibrosis |title=Cystic fibrosis - Genetics Home Reference |format= |work= |accessdate=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 244: / Line 258: @@
 |-
 | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[COPD]]
-(Severe [[emphysema]])
+(Severe [[emphysema]])<ref name="pmid25177479">{{cite journal| author=Qureshi H, Sharafkhaneh A, Hanania NA| title=Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. | journal=Ther Adv Chronic Dis | year= 2014 | volume= 5 | issue= 5 | pages= 212-27 | pmid=25177479 | doi=10.1177/2040622314532862 | pmc=4131503 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25177479  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 252: / Line 266: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Reduced breath sounds, [[Wheeze]], [[Inspiration|Inspiratory]] [[crackles]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Reduced [[breath sounds]], [[Wheeze]], [[Inspiration|Inspiratory]] [[crackles]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Polycythemia]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓[[Oxygen|O2]], ↑[[CO2]]
@@ Line 263: / Line 277: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Pulmonary hypertension]], [[Right heart failure]]
 |-
-! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary vascular congestion|Pulmonary vascular disorders]]
+![[Tuberculosis]]<ref name="OlalekanOluwaseun2015">{{cite journal|last1=Olalekan|first1=Adebimpe Wasiu|last2=Oluwaseun|first2=Faremi Ayodeji|last3=Oladele|first3=Hassan Abdul-Wasiu|last4=Akeem|first4=Adeyemi Damilare|title=Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria|journal=Alexandria Journal of Medicine|volume=51|issue=3|year=2015|pages=255–260|issn=20905068|doi=10.1016/j.ajme.2014.10.003}}</ref>
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Massive [[pulmonary embolism]]
+| -
+| +
+| +
+| +
+| +
+| +/-
+| -
+|Reduced [[breath sounds]], [[Wheeze]], [[Inspiration|Inspiratory]] [[crackles]]
+|[[Leukocytosis]], ↑[[Lymphocyte]]
+|↓[[Oxygen|O2]], ↑[[CO2]]
+![[Hyponatremia]], [[Hyperkalemia]],  [[Hypochloremia]]
+![[PPD]],
+[[Interferon-gamma release assay|interferon-gamma release assay (IGRA)]]
+!dense, homogeneous [[Consolidation (medicine)|parenchymal consolidation]]
+![[Nodules]] with low-density centers and rim enhancement
+![[Pet scan|Fluorodeoxyglucose positron emission tomography/CT (FDG PET/CT)]]
+![[Sputum culture]], [[QuantiFERON-TB Gold|QuantiFERON-TB Gold (QFT)]]
+![[Loss of appetite]], [[Night sweats]]
+|-
+![[Pulmonary fibrosis]]
+| -
+| +
+| +
+| -
+| +
+| +
+| -
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+|-
+![[Pneumoconiosis]]
+| -
+| +
+| +
+| -
+| +/-
+| +/-
+| -
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+|-
+![[Lung cancer]]
+| -
+| +
+| +
+| -
+| +/-
+| +
+| -
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+|-
+![[Acute respiratory distress syndrome]]
+| -
+| +
+| +
+| +/-
+| +
+| -
+| -
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+|-
+! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary vascular congestion|Pulmonary vascular disorders]]
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Massive [[pulmonary embolism]]<ref name="pmid23940438">{{cite journal| author=Bĕlohlávek J, Dytrych V, Linhart A| title=Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. | journal=Exp Clin Cardiol | year= 2013 | volume= 18 | issue= 2 | pages= 129-38 | pmid=23940438 | doi= | pmc=3718593 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23940438  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 302: / Line 413: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cerebral arteriovenous malformation]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" colspan="2" rowspan="2" |[[Chest wall deformities|Chest wall disorders]]
+![[Pulmonary hypertension]]
+!
+| +
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+|-
+! colspan="2" rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Chest wall deformities|Chest wall disorders]]
 | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Flail chest]]<ref name="pmid17650694">{{cite journal |vauthors=Pettiford BL, Luketich JD, Landreneau RJ |title=The management of flail chest |journal=Thorac Surg Clin |volume=17 |issue=1 |pages=25–33 |date=February 2007 |pmid=17650694 |doi=10.1016/j.thorsurg.2007.02.005 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 317: / Line 447: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |≥3 adjacent [[ribs]] with [[Rib fractures|segmental fractures]],  >5 adjacent [[Rib fracture|rib fractures]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Chest X-ray|CXR]]
@@ Line 360: / Line 490: @@
 | style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
 |-
-! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiovascular diseases]]
+! rowspan="15" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiac disease|Cardiac diseases]]
-! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Congenital disorder|Congenital disorders]]
+! rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Congenital disorder|Congenital disorders]]
 | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atrioventricular canal defect (patient information)|Atrioventricular canal defect]]<ref name="pmid15227445">{{cite journal| author=Macris MP, Ott DA, Cooley DA| title=Complete atrioventricular canal defect: surgical considerations. | journal=Tex Heart Inst J | year= 1992 | volume= 19 | issue= 3 | pages= 239-43 | pmid=15227445 | doi= | pmc=326195 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15227445  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
@@ Line 495: / Line 625: @@
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Sweating]], [[Pale skin|Pale]] or cool [[skin]]
 |-
-! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acquired disorder]]
+![[Patent ductus arteriosus]]
+| -
+| +
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+|-
+! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acquired disorder|Acquired disorders]]
 | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart failure]]<ref name="pmid27367736">{{cite journal| author=Inamdar AA, Inamdar AC| title=Heart Failure: Diagnosis, Management and Utilization. | journal=J Clin Med | year= 2016 | volume= 5 | issue= 7 | pages=  | pmid=27367736 | doi=10.3390/jcm5070062 | pmc=4961993 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27367736  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 553: / Line 702: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dizziness]], [[Fatigue]], [[Lightheadedness]], [[Cold sweat]]
 |-
-! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
+![[Cardiogenic shock]]<ref name="pmid22675405">{{cite journal| author=Werdan K, Ruß M, Buerke M, Delle-Karth G, Geppert A, Schöndube FA et al.| title=Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment: a German-Austrian S3 Guideline. | journal=Dtsch Arztebl Int | year= 2012 | volume= 109 | issue= 19 | pages= 343-51 | pmid=22675405 | doi=10.3238/arztebl.2012.0343 | pmc=3364528 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22675405  }}</ref>
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
+| +/-
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Central
+| +
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Dyspnea
+| +
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
+| -
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Chest pain
+| -
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Clubbing
+| -
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral edema
+| +
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
+![[Muffled heart sounds|Muffled heart sound]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
+![[Anemia]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |ABG
+|↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Electrolytes
+|[[Hyperkalemia]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
+|↓[[PaO2]] in [[pulse oximetry]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |X-ray
+|Normal
-! style="background:#4479BA; color: #FFFFFF;" align="center" |CT scan
+|Normal
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
+|[[Echocardiography]]
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
+|[[Clinical]] findings
-| style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
+![[Tachypnea]], [[Palpitation]], [[Hypotension]],
+Weak [[pulse]]
 |-
-! colspan="2" rowspan="3" |Central Nervous system
+![[Cardiomyopathy]]
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Methemoglobinemia]]
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-|
+!
-|
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
-* [[CBC]]
+!
-* [[Peripheral smear]]
+!
-* [[Complete metabolic profile]]
+!
-* [[Hemoglobin electrophoresis]]
+!
-* [[Serum nitrite levels]]
+!
-* [[Pulse oximetry]]
-* [[ABG's]]
-* [[Drug screen]]
-* [[LDH]]
-|
-|
-|
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* [[CXR]]
-* [[EKG]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Family history of methemoglobinemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency is important to determine.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polycythemia]]
+![[Heart tumors]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+!
-|
+!
-|
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
-* [[CBC]]
+!
-** Raised all cell lines in primary and only raised erythrocytes in secondary polycythemia
+!
-* [[Pulse oximetry]]
+!
-* [[Erythropoietin levels (EPO)]]
+!
-* [[Ferritin levels]]
+!
-* [[ABG's]]
+!
-* [[Increased leukocyte alkaline phosphatase]]
-* [[B12 levels]]
-* [[JAK 2 mutation]]
-|
-|
-|
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* [[CXR]]
-* [[EKG]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Tenderness in the sternum may indicate transformation to acute myeloid leukemia and should be properly investigated.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Breath holding spells
+![[Mitral Stenosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-|
+!
-|
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
-* No confirmatory study
+!
-* [[CBC]]
+!
-* [[Serum ferritin]]
+!
-* [[Blood lead level]]
+!
-|
+!
-|
+!
-|
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* video-EEG monitoring can be use in non diagnostic cases.
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Cyanotic breath-holding spells most commonly occur around 1 year of age with a range of six months to four years.
-* Iron deficiency anemia is more prevalent in children with breath-holding spells.
 |-
-! colspan="2" rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Miscellaneous
+! rowspan="5" |[[Vascular disease]]
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Shock]]
+! rowspan="3" |[[Arterial Insufficiency|Arterial disorders]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+![[Ddx:Acrocyanosis|Acrocyanosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + (septic shock)
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + (Cardiogenic shock)
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-|
+!
-|
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
-* [[Complete metabolic profile]]
+!
-* [[CBC]]
+!
-* [[Cardiac enzymes]]
+!
-* [[ABG's]]
+!
-* [[Lactate]]
+!
-* [[BNP]]
+!
-* [[Renal function tests]]
+!
-* [[Coagulation studies and D-dimer level]]
-|
-|
-|
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* [[Echocardiography]]
-* [[Chest radiography]]
-* [[Angiography]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Smoke inhalation
+!Arterial [[embolism]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+!
-|
+!
-|
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
-*  [[CBC]]
+!
-[[Electrolytes]]
+!
+!
-[[BUN and CR]],
+!
+!
-[[Lactate levels]]
+!
-[[Toxicology screen]]
-[[CO-oximetry]]
-|
-|
-|
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-** [[CXR]]
-** [[ECG]]
-** [[Serial cardiac enzymes]] (in patients with chest pain)\
-** [[Pulmonary function testing]]
-** [[Direct laryngoscopy and fiberoptic bronchoscopy]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* CO toxicity should be suspected in any patient who presents following smoke inhalation unless co-oximetry shows normal carboxyhemoglobin.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cold exposure
+![[Raynaud's Phenomenon]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
+!
-|
+!
-|
+!
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
-* [[Fingerstick glucose]] (Hyperglycemia)
+!
-*[[Electrocardiogram]] (ECG) may show J wave, sinus bradycardia and prolongation of all ECG intervals.
+!
+!
-*[[Serum electrolytes]] (including potassium and calcium)
+!
+!
-*[[BUN and creatinine]]
+!
-*[[Serum hemoglobin]], [[white blood cell]], and [[platelet]] counts ( Raised HCT due to volume contraction)
-*[[Coagulation profile]] acidosis)
-*[[Creatine kinase]] (Rhabdomylosis)
-*[[Arterial blood gas]]
-|
-|
-|
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* CXR
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* '''Mild hypothermia''': core temperature 32 to 35°C ; patient presents with confusion, tachycardia, and increased shivering.
-*'''Moderate hypothermia''': 28 to 32°C  patient presents with lethargy, bradycardia and arrhythmia and decreased shivering.
-*'''Severe hypothermia''': below 28°C patient presents with coma, hypotension, arrhythmia, pulmonary edema, and rigidity.
 |-
-|}
+! rowspan="2" |[[Venous insufficiency|Venous disorders]]
-|}
+![[Superior vena cava obstruction]]
+| +
-{| align="center"
+| -
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
 |-
-|
+![[Venous stasis]]
-{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
+| +
-! colspan="3" rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Causes of cyanosis
+| -
-! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cyanosis
+!
-| colspan="6" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations/association'''
+!
-! colspan="3" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diagnosis
+!
-! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Additional
+!
-findings
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
+!
 |-
-| colspan="3" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms'''
+! colspan="3" |Disease
-! colspan="3" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs
+|Peripheral
+|Central
+|Dyspnea
+|Fever
+|Chest pain
+|Clubbing
+|Peripheral edema
+|Auscultation
+!CBC
+!ABG
+!Electrolytes
+!Other
+!X-ray
+!CT scan
+!Other
+|Gold standard
+|Additional findings
 |-
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
+! colspan="2" rowspan="2" |[[Hematologic diseases]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Central
+| colspan="1" rowspan="1" |[[Methemoglobinemia]]<ref name="pmid21954509">{{cite journal |vauthors=Ashurst J, Wasson M |title=Methemoglobinemia: a systematic review of the pathophysiology, detection, and treatment |journal=Del Med J |volume=83 |issue=7 |pages=203–8 |date=July 2011 |pmid=21954509 |doi= |url=}}</ref>
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Dyspnea
+| -
-! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Fever
+| +
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Chest pain
+| +
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Clubbing
+| +/-
-! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral edema
+| +
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
+| -
-! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Lab Findings
+| -
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
+|[[Wheezing]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
+|[[Anemia]], [[Methemoglobinemia]]
+|Normal [[PaO2]], ↑[[Oxygen saturation|SaO2]], "Saturation gap"
+|Normal
+|↓[[Oxygen saturation|SaO2]] in [[pulse oximetry]]
+|Normal
+|Normal
+|[[Echocardiography]] for ruling out other causes
+|[[Oximetry|Co-oximetry]], [[Arterial blood gas|ABG]] paired with [[pulse oximetry]]. Serum [[methemoglobin]] levels
+|[[Headache]], [[Altered mental status]], [[Delirium]], [[Seizure]], [[Coma]]
 |-
-! rowspan="14" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Respiratory
+|[[Polycythemia]]<ref name="pmid11841424">{{cite journal |vauthors=Spivak JL |title=The optimal management of polycythaemia vera |journal=Br. J. Haematol. |volume=116 |issue=2 |pages=243–54 |date=February 2002 |pmid=11841424 |doi= |url=}}</ref>
-! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Airway
+| +
-disorder
+| +
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Severe [[croup]]<ref name="Cherry2008">{{cite journal|last1=Cherry|first1=James D.|title=Croup|journal=New England Journal of Medicine|volume=358|issue=4|year=2008|pages=384–391|issn=0028-4793|doi=10.1056/NEJMcp072022}}</ref>
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| +/-
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
+| +/-
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
+|Normal
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
+|↑[[RBC]], ↑[[WBC]], ↑[[Hemoglobin|HGB]], ↑[[Platelet|Plt]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
+|↓[[Oxygen|O2]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Audible [[stridor]] at rest
+|[[Hyperkalemia]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|↑[[Leukocyte alkaline phosphatase]], ↑[[Ferritin]], ↑[[Erythropoietin]]
-* [[Lymphocytosis]]
+|[[Arteriovenous malformation|AVM]], [[COPD]], [[pulmonary hypertension]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |AP Neck X ray for soft tissues:
+|Normal
-* [[Steeple sign]]
+|[[Ultrasound|Abdominal ultrasound]] or renal vascular studies for ruling out [[renal artery stenosis]]
-Lateral neck X ray:
+|[[RBC]] mass (RCM) and [[Blood plasma|plasma volume]] measurement
-* Distended [[hypopharynx]] during [[inspiration]]
+|[[Itchiness]], [[Headache]]. [[Dizziness]]. [[Blurred vision]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Clinical diagnosis
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Croupy cough and [[stridor]]
-* Intercostal, subcostal retractions
 |-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Epiglottitis]]
+! colspan="2" rowspan="4" |[[Neurological disease]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+|[[Breath-holding spells]]<ref name="pmid25676645">{{cite journal| author=Goldman RD| title=Breath-holding spells in infants. | journal=Can Fam Physician | year= 2015 | volume= 61 | issue= 2 | pages= 149-50 | pmid=25676645 | doi= | pmc=4325862 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25676645  }}</ref>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
+| +/-
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Stridor]]
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|[[Wheezing]]
-* [[Leukocytosis]] with [[neutrophilia]]
+|[[Microcytic anemia|Hypochromic microcytic anemia]]
-* Blood cultures
+|↓[[Oxygen|O2]]
-* Throat culture in intubated patients
+|[[Hypocalcemia]], [[Hypokalemia]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Lateral neck X ray
+|[[Iron deficiency]]
-* [[Thumbprint sign]] (swollen epiglottis)
+|Ruling out [[foreign body aspiration]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|Normal
-* [[Laryngoscopy]]
+|[[EEG]] monitoring
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|[[Clinical]] findings
-* [[Sore Throat]]
+|[[Fainting]], [[Twitching|Twitching muscles]], [[Seizure]]
-* [[Dysphagia]]
-* [[Odynophagia]]
-* Muffled voice
-* Drooling
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Coma]]
+![[Seizure]]<ref name="pmid20689626">{{cite journal| author=Goldenberg MM| title=Overview of drugs used for epilepsy and seizures: etiology, diagnosis, and treatment. | journal=P T | year= 2010 | volume= 35 | issue= 7 | pages= 392-415 | pmid=20689626 | doi= | pmc=2912003 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20689626  }}</ref>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+|Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|↓[[Oxygen|O2]], ↑[[CO2]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|[[Hyponatremia]], [[Hypocalcemia|Hypo]]/[[Hypercalcemia]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!↑[[Creatine kinase|CPK]], ↑[[LDH]],
+|Normal
+|Normal
+|[[EEG]]
+|[[EEG]]
+|[[Fainting]], [[Tonic-clonic|Tonic-clonic movements]]
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Seizure|Seizure<nowiki/>s]]
+![[Coma]]<ref name="pmid21190458">{{cite journal| author=Brown EN, Lydic R, Schiff ND| title=General anesthesia, sleep, and coma. | journal=N Engl J Med | year= 2010 | volume= 363 | issue= 27 | pages= 2638-50 | pmid=21190458 | doi=10.1056/NEJMra0808281 | pmc=3162622 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21190458  }}</ref>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+|[[Wheezing]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|↓[[Oxygen|O2]], ↑[[CO2]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+| -
+|Underlying [[disease]]
+|Underlying [[disease]]
+| -
+![[Glasgow coma scale|Glasgow Coma Scale (GCS)]]
+!Depressed [[brainstem]] reflexes, [[Agonal breathing]]
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Head trauma
+![[Head trauma]]<ref name="pmid22033563">{{cite journal| author=McAllister TW| title=Neurobiological consequences of traumatic brain injury. | journal=Dialogues Clin Neurosci | year= 2011 | volume= 13 | issue= 3 | pages= 287-300 | pmid=22033563 | doi= | pmc=3182015 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22033563  }}</ref>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+|Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|↓[[Oxygen|O2]], ↑[[CO2]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+| -
+![[Skull fracture]]
+![[Intracranial hemorrhage]]
+![[MRI]]
+![[CT scan]]
+![[Nausea]], [[Hypertension]], [[Bradycardia]],[[Tachypnea]]
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Breath holding spells
+! colspan="2" rowspan="4" |Miscellaneous
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+![[High altitude exposure]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| +
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+!
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+!
+!
+!
+!
+!
+!
+!
 |-
-! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Miscellaneous
+| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Septic shock]]<ref name="pmid28117397">{{cite journal| author=Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL| title=Sepsis and septic shock. | journal=Nat Rev Dis Primers | year= 2016 | volume= 2 | issue=  | pages= 16045 | pmid=28117397 | doi=10.1038/nrdp.2016.45 | pmc=5538252 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28117397  }}</ref>
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Shock]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Rales]], [[crackles]], [[Wheeze]], [[Pleural friction rub]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+|[[Leukocytosis]] with [[neutrophilia]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|↓[[Oxygen|O2]], ↑[[CO2]], [[Metabolic acidosis]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Hyperkalemia]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|↑[[ESR]], ↑[[CRP]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+|[[Consolidation (medicine)|Consolidation]]
+|[[Pulmonary]] infiltration
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Echocardiography]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Blood culture]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Chills]], [[Hypothermia]], [[Loss of consciousness]]
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Smoke inhalation
+| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Smoke inhalation]]<ref name="pmid20161170">{{cite journal| author=Rehberg S, Maybauer MO, Enkhbaatar P, Maybauer DM, Yamamoto Y, Traber DL| title=Pathophysiology, management and treatment of smoke inhalation injury. | journal=Expert Rev Respir Med | year= 2009 | volume= 3 | issue= 3 | pages= 283-297 | pmid=20161170 | doi=10.1586/ERS.09.21 | pmc=2722076 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20161170  }}</ref>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Wheezing]]
+|[[Anemia]], [[Carboxyhemoglobin]]
+|↓[[Oxygen|O2]], ↑[[CO2]], [[Respiratory acidosis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal
+|[[Pulse oximetry|CO-oximetry]]
+|Diffuse [[Opacity|opacities]]
+|[[Pulmonary]] infiltration
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Pulmonary function testing]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Bronchoscopy]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Cough]], [[Hoarseness]], [[Hemoptysis]], [[Headache]], [[Fainting]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cold exposure]]<ref>{{cite book | last = Marriott | first = Bernadette | title = Nutritional needs in cold and in high-altitude environments : applications for military personnel in field operations | publisher = National Academy Press | location = Washington, D.C | year = 1996 | isbn = 0-309-05484-2 }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
+|[[Leukopenia]], ↑[[RBC]]
+|↓[[Oxygen|O2]], ↑[[CO2]], [[Metabolic acidosis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Hypokalemia]], [[Hypocalcemia]]
+|Hyperglycemia, ↑[[Creatine kinase|CK]]
+|Normal
+|Normal
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Clinical]] findings
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* '''Mild ('''32-35°C): [[Confusion]], [[tachycardia]], and increased ↑[[shivering]].
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cold exposure
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-*[[Complete blood count|CBC]]
-*Fingerstick glucose (Hyperglycemia)
-*EKG-
-**J wave
-**Sinus bradycardia
-**Prolongation of all ECG intervals.
-*Serum electrolytes -K+ and calcium
+*'''Moderate ('''28-32°C): [[Lethargy]], [[bradycardia]], [[arrhythmia]] and  ↓[[shivering]].
-*[[BUN]] and [[creatinine]]
+*'''Severe (<'''28°C) [[Coma]], [[hypotension]], [[arrhythmia]], [[pulmonary edema]], and rigidity.
+|-
+|}
+|}
-*[[PT]], [[PTT]]
+{| align="center"
-*S. [[lactate]]
-*ABG
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-*'''Mild hypothermia''': core temperature 32 to 35°C ;
-**[[Confusion]]
-**[[Tachycardia]]
-**Increased shivering.
-*'''Moderate hypothermia''': 28 to 32°C
-**[[Lethargy]]
-**[[Bradycardia]]
-**[[Arrhythmia]]
-**Decreased shivering.
-*'''Severe hypothermia''': <28°C
-**[[Coma]]
-**[[Hypotension]]
-**[[Arrhythmias|Arrhythmia]]
-**[[Pulmonary edema]]
-**Rigidity
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Drugs†
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 |-
-|}
+|
+[[Seizure|<nowiki/>]]
 |}
 ==References==
 {{Reflist|2}}
 [[Category:Needs content]]
 [[Category:Dermatology]]

Cyanosis differential diagnosis: Difference between revisions

Revision as of 20:51, 9 March 2018

Overview

Differential diagnosis

References

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