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==Differential diagnosis==
==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> 
{| align="center"
|-
|
[[Seizure|<nowiki/>]]
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
! colspan="2" rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Causes of cyanosis
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
! 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" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
! style="background:#4479BA; color: #FFFFFF;" align="center" |Central
! 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
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
|-
! rowspan="13" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Respiratory
! 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="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" |✔
| 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" |Audible [[stridor]] at rest
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Lymphocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |AP Neck X ray for soft tissues:
*[[Steeple sign]]
Lateral neck X ray:
*Distended [[hypopharynx]] during [[inspiration]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| 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]]
| 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" |[[Stridor]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Leukocytosis]] with [[neutrophilia]]
*Blood cultures
*Throat culture in intubated patients
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Lateral neck X ray
*[[Thumbprint sign]] (swollen epiglottis)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Laryngoscopy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Sore Throat]]
*[[Dysphagia]]
*[[Odynophagia]]
*Muffled voice


<span style="font-size:85%">'''Abbreviations:'''
<span style="font-size:85%">'''Abbreviations:'''
Line 177: Line 252:
*Urine antigen
*Urine antigen
| 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" |
*[[Tachycardia]]
*[[Tachycardia]]
Line 206: Line 280:
*[[Bronchiectasis]]
*[[Bronchiectasis]]
| 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" |
*Reversible obstructive disease
*Reversible obstructive disease
Line 362: Line 435:
! rowspan="13" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cardiovascular  
! rowspan="13" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cardiovascular  
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumothorax]]
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumothorax]]
| |✔
| 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" |−
| colspan="1" rowspan="1" |−
| colspan="1" rowspan="1" style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
*Decreased breath sounds
*Decreased breath sounds
*[[Wheezing]]
*[[Wheezing]]
| |
| 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: #DCDCDC;" align="center" |
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |
| style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
| style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
Line 447: Line 520:
| 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" |+ (systolic)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + (systolic)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[CBC]]
* [[CBC]]
Line 471: Line 544:
| 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" |+ (systolic)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + (systolic)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[CBC]]
* [[CBC]]
Line 495: Line 568:
| 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" |+ (Systolic)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + (Systolic)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[CBC]]
* [[CBC]]
Line 519: Line 592:
| 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" |-
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[CBC]]
* [[CBC]]
Line 543: Line 616:
| 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" |±
Line 559: Line 632:
* [[MRI]]
* [[MRI]]
* [[Cardiac catheterization]]
* [[Cardiac catheterization]]
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Echocardiography]]
* [[Echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
Line 668: Line 741:
|-
|-
! colspan="2" rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Central Nervous system
! colspan="2" rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Central Nervous system
! style="background:#4479BA; color: #FFFFFF;" align="center" |
! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
! style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
! style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
! style="background:#4479BA; color: #FFFFFF;" align="center" |Central
! style="background:#4479BA; color: #FFFFFF;" align="center" |Central
Line 685: Line 758:
| 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" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[CBC]]
* [[CBC]]
Line 704: Line 777:
* [[CXR]]
* [[CXR]]
* [[EKG]]
* [[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]]
| 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="background:#4479BA; color: #FFFFFF;" align="center" |Disease
! 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
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral edema
! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
! style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Breath holding spells
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
{| class="wikitable"
|✔
|}
| 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
| 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" | + (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: #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]]
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Smoke inhalation
| 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
| 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.
|-
|}
|}
 
 
 
 
 
 
 
 
 
 
 
 
 
 
{| align="center"
|-
|
{| 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" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
! style="background:#4479BA; color: #FFFFFF;" align="center" |Central
! 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
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
|-
! rowspan="14" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Respiratory
! 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" |−
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Audible [[stridor]] at rest
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Lymphocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |AP Neck X ray for soft tissues:
* [[Steeple sign]]
Lateral neck X ray:
* Distended [[hypopharynx]] during [[inspiration]]
| 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]]
| 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" |[[Stridor]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Leukocytosis]] with [[neutrophilia]]
* Blood cultures
* Throat culture in intubated patients
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Lateral neck X ray
* [[Thumbprint sign]] (swollen epiglottis)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Laryngoscopy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Sore Throat]]
* [[Dysphagia]]
* [[Odynophagia]]
* Muffled voice
* Drooling
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Coma]]
| 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" |
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Seizure|Seizure<nowiki/>s]]
| 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" |
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Head trauma
| 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="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" |
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Breath holding spells
| 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" |+
! 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" |[[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="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" |
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Smoke inhalation
| 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" |
| 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: #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
 
*[[BUN]] and [[creatinine]]
 
*[[PT]], [[PTT]]
 
*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" |
|-
|}
|}
 
 
 
 
 
<references />
 
==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> 
{| align="center"
|-
|
[[Seizure|<nowiki/>]]
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
! colspan="2" rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Causes of cyanosis
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
! 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" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
! style="background:#4479BA; color: #FFFFFF;" align="center" |Central
! 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
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
|-
! rowspan="13" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Respiratory
! 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="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" |✔
| 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" |Audible [[stridor]] at rest
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Lymphocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |AP Neck X ray for soft tissues:
*[[Steeple sign]]
Lateral neck X ray:
*Distended [[hypopharynx]] during [[inspiration]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| 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]]
| 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" |[[Stridor]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Leukocytosis]] with [[neutrophilia]]
*Blood cultures
*Throat culture in intubated patients
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Lateral neck X ray
*[[Thumbprint sign]] (swollen epiglottis)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Laryngoscopy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Sore Throat]]
*[[Dysphagia]]
*[[Odynophagia]]
*Muffled voice
*Drooling
|-
| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Foreign body aspiration]]
| 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" |
*Decreased breath sounds
*[[Wheezing]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[ABG|ABGs]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CXR
*Hyperinflation (children)
*[[Atelectasis]] (adults)
*Objects
[[CT scan]]
*Foreign body
*Entrapment with [[edema]] or [[granulation tissue]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Bronchoscopy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Complications:
*Inflammation
*[[Mediastinitis]]
*Local [[emphysema]]
*[[Atelectasis]]
*Cyanosis
|-
| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Bacterial tracheitis]]
| 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" |
*Inspiratory [[stridor]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Blood cultures]]
*[[Gram stain]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Lateral neck X ray
*Confusing
*[[Steeple sign]]
*Irregular tracheal margin
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Laryngotracheo[[Bronchoscopy|-bronchoscopy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Brassy cough
*Retractions
*No drooling
*Hoarseness
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
! 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
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral edema
! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
! style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
|-
! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Parenchymal
disorder
| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumonia]]
| 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" |
*Reduced breath sounds
*Rales, [[crackles]], wheeze
*[[Pleural friction rub]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[ABG|ABGs]]
*Leukocytosis
*Pancytopenia
*[[Hyponatremia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*CXR
*CT chest
*Bronchoscopy
*Sputum culture and gram stain
*Blood cultures
*Urine antigen
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Tachycardia]]
*[[Bradycardia]]  ([[Legionella]])
*[[CURB-65]]
|-
| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Asthma]]
(Late)
| 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" |✔ in [[interstitial lung disease]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
*End expiratory [[wheeze]]
*Absent [[wheeze]] and breath sounds in severe form
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[ABG]]
*[[Eosinophilia]]
*[[IgE]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CXR
*to rule out other diagnosis
*complications like pneumonia, [[atelactasis]]
HRCT
*[[Allergic bronchopulmonary aspergillosis]]
*[[Bronchiectasis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Reversible obstructive disease
*[[Peak expiratory flow]] measurement is easy and very helpful
*[[GERD]] is a cause in case of refractory asthma.
*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]]
| 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" |when infected
| 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" |[[Wheeze]] or crackles
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Sputum stain and culture
*[[Sweat test]]
*Genetic test for [[CFTR (gene)]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CXR
*Hyperinflation
*Peribronchial thickening
*Nodules
*[[Bronchiectasis]]
HRCT for detecting lung changes
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Sweat test
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Usually present since birth
*Recurrent pneumonia
*Recurrent wheezing
*Recurrent sinusitis
*Gastrointestinal manifestations
**[[Meconium ileus]]
**[[Pancreatic insufficiency]]
|-
| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[COPD]]
(Severe [[emphysema]])
| 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" |
*Reduced breath sounds
*Prolonged  expiration
*[[Wheeze]]
*Inspiratory [[crackles]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hematocrit]]
*[[ABG]]
*Sputum staining and culture
*[[Alpha 1-antitrypsin deficiency laboratory tests|Alpha 1-antitrypsin test]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CXR
*Elongated heart
*Flattening of diaphragms
*Prominent hilar vasculature
HRCT
*Bullae
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*HRCT
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Pulmonary hypertension]]
*[[Right heart failure]]
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
! 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
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral edema
! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
! style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
|-
! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pulmonary vascular disorders
| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Massive [[pulmonary 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" |✔
| 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
*Rales, crackles
*Loud [[P2]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[ABG|ABGs]]
*D-dimer
*EKG
*[[BNP]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*CXR
*V/Q scan
*Spiral [[CT pulmonary angiogram]]
*Venous ultrasound for [[DVT]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Spiral [[CT pulmonary angiogram]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Tachycardia]]
*[[Shock]]
*[[Pulmonary hypertension]] can occur
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary arterio-venous malformation]]<ref name="pmid119300212">{{cite journal |vauthors=Khurshid I, Downie GH |title=Pulmonary arteriovenous malformation |journal=Postgrad Med J |volume=78 |issue=918 |pages=191–7 |year=2002 |pmid=11930021 |pmc=1742331 |doi= |url=}}</ref><ref name="pmid195683982">{{cite journal |vauthors=Doshi HM, Robinson S, Chalhoub T, Jack S, Denison A, Gibson G |title=Massive spontaneous hemothorax during the immediate postpartum period |journal=Tex Heart Inst J |volume=36 |issue=3 |pages=247–9 |year=2009 |pmid=19568398 |pmc=2696501 |doi= |url=}}</ref><ref name="pmid15541322">{{cite journal |vauthors=Chanatry BJ |title=Acute hemothorax owing to pulmonary arteriovenous malformation in pregnancy |journal=Anesth. Analg. |volume=74 |issue=4 |pages=613–5 |year=1992 |pmid=1554132 |doi= |url=}}</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" |
*Pulmonary bruit
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[CBC]]
*[[ABG]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CXR
*Round/oval mass
**lobulated
**well defined
*Connecting vessel in hilum
*[[Hemothorax]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Pulmonary angiography]]
*Contrast [[echocardiography]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Classic triad of [[dyspnea on exertion]], [[cyanosis]] and [[clubbing]]
*[[Cerebral arteriovenous malformation]]
*[[Pregnancy]] can increase the size
|-
! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Chest <br> wall disorders
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Flail chest]]
| 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" |
|-
! rowspan="13" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cardiovascular
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumothorax]]
| 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" |−
| colspan="1" rowspan="1" style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
*Decreased breath sounds
*[[Wheezing]]
| 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: #DCDCDC;" align="center" |
| style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| 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
| colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral edema
| style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
| style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
| style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |
| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |
[[Atrioventricular canal defect (patient information)|Atrioventricular canal defect]]
| 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]]
* [[EKG]]
* [[Pulse oximetry]]
 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[CXR]] (Cardiac enlargement, Increased pulmonary vascular markings)
 
*[[Echocardiography]]
*[[MRI]]
*[[Cardiac catheterization]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
** [[Echocardiography]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ebstein anomaly]]
| 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" |
* [[CBC]]
* [[EKG]]
* [[Pulse oximetry]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[CXR]] (Cardiac enlargement, decreased pulmonary vascular markings)
 
* [[Echocardiography]]
* [[MRI]]
* [[Cardiac catheterization]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Echocardiography]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tetralogy of Fallot]]
| 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" | + (systolic)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[CBC]]
* [[EKG]]
* [[Pulse oximetry]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[CXR]] (Boot shaped heart, decreased pulmonary vascular markings)
 
*[[Echocardiography]]
*[[MRI]]
*[[Cardiac catheterization]]
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonic 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" | + (systolic)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[CBC]]
* [[EKG]]
* [[Pulse oximetry]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[CXR]] (Cardiac enlargement, decreased pulmonary vascular markings)
 
* [[Echocardiography]]
* [[MRI]]
* [[Cardiac catheterization]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Total anomalous pulmonary venous drainage|Total anomalous pulmonary]]  [[Total anomalous pulmonary venous drainage|venous connection]]
| 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" | + (Systolic)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[CBC]]
* [[EKG]]
* [[Pulse oximetry]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[CXR]] (normal heart size and venous congestion but in patients without obstruction have cardiomegaly and increased pulmonary blood flow.)
 
* [[Echocardiography]]
* [[MRI]]
* [[Cardiac catheterization]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Transposition of the great vessels]]
| 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" |
* [[CBC]]
* [[EKG]]
* [[Pulse oximetry]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[CXR]] (Cardiac enlargement, increased pulmonary vascular markings)
 
* [[Echocardiography]]
* [[MRI]]
* [[Cardiac catheterization]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Truncus arteriosus]]
| 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" |sys/±dias
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[CBC]]
* [[EKG]]
* [[Pulse oximetry]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[CXR]] (Cardiac enlargement, increased pulmonary vascular markings)
 
* [[Echocardiography]]
* [[MRI]]
* [[Cardiac catheterization]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
! rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |
! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
! 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
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral edema
! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
! style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart failure]]
| 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" | +
([[S3]])
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[CBC]]
* Complete metabolic profile
* Cardiac enzymes
* BNP
* [[Thyroid function tests|Thyroid profile]]
* [[Renal function tests]]
* EKG
* [[Exercise stress testing|Exercise stress test]]
* [[ABG|ABG's]]
* [[Lipid profile]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* CXR
** Increase in heart size compared to the old film.
** Pleural fluid
** Interstitial edema
* Echocardiography
* Angiography
* Cardiac MRI
* Nuclear imaging
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Echocardiography]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Endomyocardial biopsy can be used when a specific diagnosis is suspected that would influence therapy in heart failure patients.
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Valvular heart disease]]
| 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]]
* [[Complete metabolic profile]]
* [[Cardiac enzymes]]
* [[BNP]]
* [[Thyroid profile]]
* [[Renal function tests]]
* [[EKG]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[CXR]]
** To assess pulomary congestion or other lung pathology.
* [[Echocardiography]]
* [[Doppler echocardiography]]
* [[Angiography]]
** To assess the need for concomitant coronary artery bypass surgery in elderly people.
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Echocardiography]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Myocardial infarction]]
| 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
* [[Complete metabolic profile
* [[Cardiac enzymes
* [[BNP]]
* [[Thyroid profile]]
* [[Renal function tests]]
* [[EKG]]
* [[Lipid profile]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[CXR]]
** Normal or may show signs of [[CHF]]
* [[Echocardiography]]
* [[Angiography]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
! colspan="2" rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Central Nervous system
! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
! 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
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral edema
! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
! style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
|-
| 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]]
| 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" |
* [[CBC]]
* [[CBC]]
Line 729: Line 1,920:
* [[CXR]]
* [[CXR]]
* [[EKG]]
* [[EKG]]
! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| 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: #F5F5F5;" align="left" |Tenderness in the sternum may indicate transformation to acute myeloid leukemia and should be properly investigated.
|-
|-
!Disease
! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
!Peripheral
! style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
!Central
! style="background:#4479BA; color: #FFFFFF;" align="center" |Central
!Dyspnea
! style="background:#4479BA; color: #FFFFFF;" align="center" |Dyspnea
!Fever
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
!Chest pain
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chest pain
!Clubbing
! style="background:#4479BA; color: #FFFFFF;" align="center" |Clubbing
! colspan="1" rowspan="1" |Peripheral edema
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral edema
!Auscultation
! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
!Lab Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
!Imaging
! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
!Gold standard
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
!Additional findings
! style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Breath holding spells
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Breath holding spells
Line 774: Line 1,965:
| 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" |+ (septic shock)
| 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" |
| 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" | + (Cardiogenic shock)
| 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" |
Line 862: Line 2,053:
|}
|}
|}
|}
{| align="center"
|-
|
{| 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" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Peripheral
! style="background:#4479BA; color: #FFFFFF;" align="center" |Central
! 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
! style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
|-
! rowspan="14" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Respiratory
! 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" |−
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Audible [[stridor]] at rest
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Lymphocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |AP Neck X ray for soft tissues:
* [[Steeple sign]]
Lateral neck X ray:
* Distended [[hypopharynx]] during [[inspiration]]
| 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]]
| 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" |[[Stridor]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Leukocytosis]] with [[neutrophilia]]
* Blood cultures
* Throat culture in intubated patients
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Lateral neck X ray
* [[Thumbprint sign]] (swollen epiglottis)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Laryngoscopy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Sore Throat]]
* [[Dysphagia]]
* [[Odynophagia]]
* Muffled voice
* Drooling
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Coma]]
| 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" |
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Seizure|Seizure<nowiki/>s]]
| 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" |
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Head trauma
| 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" |
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Breath holding spells
| 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" |
|-
! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Miscellaneous
| 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="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" |
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Smoke inhalation
| 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" |
| 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: #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
*[[BUN]] and [[creatinine]]
*[[PT]], [[PTT]]
*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" |
|-
|}
|}
<references />
<references />

Latest revision as of 19:06, 13 June 2018


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

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

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[1] Audible stridor at rest AP Neck X ray for soft tissues:

Lateral neck X ray:

  • Croupy cough and stridor
  • Intercostal, subcostal retractions
Epiglottitis Stridor Lateral neck X ray

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

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[1] Audible stridor at rest AP Neck X ray for soft tissues:

Lateral neck X ray:

  • Croupy cough and stridor
  • Intercostal, subcostal retractions
Epiglottitis Stridor Lateral neck X ray
Foreign body aspiration CXR

CT scan

Complications:
Bacterial tracheitis Lateral neck X ray
  • Brassy cough
  • Retractions
  • No drooling
  • Hoarseness
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Parenchymal

disorder

Pneumonia
  • CXR
  • CT chest
  • Bronchoscopy
  • Sputum culture and gram stain
  • Blood cultures
  • Urine antigen
Asthma

(Late)

✔ in interstitial lung disease
  • End expiratory wheeze
  • Absent wheeze and breath sounds in severe form
CXR
  • to rule out other diagnosis
  • complications like pneumonia, atelactasis

HRCT

Cystic fibrosis when infected Wheeze or crackles CXR

HRCT for detecting lung changes

  • Sweat test
COPD

(Severe emphysema)

  • Reduced breath sounds
  • Prolonged expiration
  • Wheeze
  • Inspiratory crackles
CXR
  • Elongated heart
  • Flattening of diaphragms
  • Prominent hilar vasculature

HRCT

  • Bullae
  • HRCT
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Pulmonary vascular disorders Massive pulmonary embolism
  • Reduced breath sounds
  • Rales, crackles
  • Loud P2
Pulmonary arterio-venous malformation[2][3][4]
  • Pulmonary bruit
CXR
  • Round/oval mass
    • lobulated
    • well defined
  • Connecting vessel in hilum
  • Hemothorax
Chest
wall disorders
Flail chest
Cardiovascular Pneumothorax
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings

Atrioventricular canal defect

+ ± +
  • CXR (Cardiac enlargement, Increased pulmonary vascular markings)
Ebstein anomaly + ± +
  • CXR (Cardiac enlargement, decreased pulmonary vascular markings)
Tetralogy of Fallot + ± + (systolic)
  • CXR (Boot shaped heart, decreased pulmonary vascular markings)
Pulmonic stenosis + ± + (systolic)
  • CXR (Cardiac enlargement, decreased pulmonary vascular markings)
Total anomalous pulmonary venous connection + ± + (Systolic)
  • CXR (normal heart size and venous congestion but in patients without obstruction have cardiomegaly and increased pulmonary blood flow.)
Transposition of the great vessels + ± -
  • CXR (Cardiac enlargement, increased pulmonary vascular markings)
Truncus arteriosus + ± sys/±dias
  • CXR (Cardiac enlargement, increased pulmonary vascular markings)
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Heart failure + + + +

(S3)

  • CXR
    • Increase in heart size compared to the old film.
    • Pleural fluid
    • Interstitial edema
  • Echocardiography
  • Angiography
  • Cardiac MRI
  • Nuclear imaging
  • Endomyocardial biopsy can be used when a specific diagnosis is suspected that would influence therapy in heart failure patients.
Valvular heart disease ± + +
Myocardial infarction + + +
Central Nervous system Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Methemoglobinemia + + + Family history of methemoglobinemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency is important to determine.
Polycythemia + + Tenderness in the sternum may indicate transformation to acute myeloid leukemia and should be properly investigated.
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Breath holding spells
  • video-EEG monitoring can be use in non diagnostic cases.
  • 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. 
Miscellaneous Shock + + (septic shock) + + (Cardiogenic shock)
Smoke inhalation + + +

Electrolytes

BUN and CR,

Lactate levels

Toxicology screen

CO-oximetry 

  • CO toxicity should be suspected in any patient who presents following smoke inhalation unless co-oximetry shows normal carboxyhemoglobin.
Cold exposure
  • CXR
  • 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.








Causes of cyanosis 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[5] Audible stridor at rest AP Neck X ray for soft tissues:

Lateral neck X ray:

Clinical diagnosis
  • Croupy cough and stridor
  • Intercostal, subcostal retractions
Epiglottitis Stridor Lateral neck X ray










Coma
Seizures
Head trauma
Breath holding spells
Miscellaneous Shock
Smoke inhalation + + +
Cold exposure
  • CBC
  • Fingerstick glucose (Hyperglycemia)
  • EKG-
    • J wave
    • Sinus bradycardia
    • Prolongation of all ECG intervals.
  • Serum electrolytes -K+ and calcium
  • ABG
Drugs†



  1. 1.0 1.1 Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.
  2. Khurshid I, Downie GH (2002). "Pulmonary arteriovenous malformation". Postgrad Med J. 78 (918): 191–7. PMC 1742331. PMID 11930021.
  3. 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.
  4. Chanatry BJ (1992). "Acute hemothorax owing to pulmonary arteriovenous malformation in pregnancy". Anesth. Analg. 74 (4): 613–5. PMID 1554132.
  5. Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.

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

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[1] Audible stridor at rest AP Neck X ray for soft tissues:

Lateral neck X ray:

  • Croupy cough and stridor
  • Intercostal, subcostal retractions
Epiglottitis Stridor Lateral neck X ray
Foreign body aspiration CXR

CT scan

Complications:
Bacterial tracheitis Lateral neck X ray
  • Brassy cough
  • Retractions
  • No drooling
  • Hoarseness
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Parenchymal

disorder

Pneumonia
  • CXR
  • CT chest
  • Bronchoscopy
  • Sputum culture and gram stain
  • Blood cultures
  • Urine antigen
Asthma

(Late)

✔ in interstitial lung disease
  • End expiratory wheeze
  • Absent wheeze and breath sounds in severe form
CXR
  • to rule out other diagnosis
  • complications like pneumonia, atelactasis

HRCT

Cystic fibrosis when infected Wheeze or crackles CXR

HRCT for detecting lung changes

  • Sweat test
COPD

(Severe emphysema)

  • Reduced breath sounds
  • Prolonged expiration
  • Wheeze
  • Inspiratory crackles
CXR
  • Elongated heart
  • Flattening of diaphragms
  • Prominent hilar vasculature

HRCT

  • Bullae
  • HRCT
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Pulmonary vascular disorders Massive pulmonary embolism
  • Reduced breath sounds
  • Rales, crackles
  • Loud P2
Pulmonary arterio-venous malformation[2][3][4]
  • Pulmonary bruit
CXR
  • Round/oval mass
    • lobulated
    • well defined
  • Connecting vessel in hilum
  • Hemothorax
Chest
wall disorders
Flail chest
Cardiovascular Pneumothorax
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings

Atrioventricular canal defect

+ ± +
  • CXR (Cardiac enlargement, Increased pulmonary vascular markings)
Ebstein anomaly + ± +
  • CXR (Cardiac enlargement, decreased pulmonary vascular markings)
Tetralogy of Fallot + ± + (systolic)
  • CXR (Boot shaped heart, decreased pulmonary vascular markings)
Pulmonic stenosis + ± + (systolic)
  • CXR (Cardiac enlargement, decreased pulmonary vascular markings)
Total anomalous pulmonary venous connection + ± + (Systolic)
  • CXR (normal heart size and venous congestion but in patients without obstruction have cardiomegaly and increased pulmonary blood flow.)
Transposition of the great vessels + ± -
  • CXR (Cardiac enlargement, increased pulmonary vascular markings)
Truncus arteriosus + ± sys/±dias
  • CXR (Cardiac enlargement, increased pulmonary vascular markings)
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Heart failure + + + +

(S3)

  • CXR
    • Increase in heart size compared to the old film.
    • Pleural fluid
    • Interstitial edema
  • Echocardiography
  • Angiography
  • Cardiac MRI
  • Nuclear imaging
  • Endomyocardial biopsy can be used when a specific diagnosis is suspected that would influence therapy in heart failure patients.
Valvular heart disease ± + +
Myocardial infarction + + +
Central Nervous system Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Methemoglobinemia + + + Family history of methemoglobinemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency is important to determine.
Polycythemia + + Tenderness in the sternum may indicate transformation to acute myeloid leukemia and should be properly investigated.
Disease Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation Lab Findings Imaging Gold standard Additional findings
Breath holding spells
  • video-EEG monitoring can be use in non diagnostic cases.
  • 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. 
Miscellaneous Shock + + (septic shock) + + (Cardiogenic shock)
Smoke inhalation + + +

Electrolytes

BUN and CR,

Lactate levels

Toxicology screen

CO-oximetry 

  • CO toxicity should be suspected in any patient who presents following smoke inhalation unless co-oximetry shows normal carboxyhemoglobin.
Cold exposure
  • CXR
  • 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.








Causes of cyanosis 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[5] Audible stridor at rest AP Neck X ray for soft tissues:

Lateral neck X ray:

Clinical diagnosis
  • Croupy cough and stridor
  • Intercostal, subcostal retractions
Epiglottitis Stridor Lateral neck X ray










Coma
Seizures
Head trauma
Breath holding spells
Miscellaneous Shock
Smoke inhalation + + +
Cold exposure
  • CBC
  • Fingerstick glucose (Hyperglycemia)
  • EKG-
    • J wave
    • Sinus bradycardia
    • Prolongation of all ECG intervals.
  • Serum electrolytes -K+ and calcium
  • ABG
Drugs†



  1. Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.
  2. Khurshid I, Downie GH (2002). "Pulmonary arteriovenous malformation". Postgrad Med J. 78 (918): 191–7. PMC 1742331. PMID 11930021.
  3. 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.
  4. Chanatry BJ (1992). "Acute hemothorax owing to pulmonary arteriovenous malformation in pregnancy". Anesth. Analg. 74 (4): 613–5. PMID 1554132.
  5. Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.