Investigations and Diagnosis Flashcards
Asthma
PEFR
Spirometry
Pulmonary function testing
Response to treatment
COPD
Spirometry
Pulmonary function testing
CXR
Response to bronchodilator (minimal response expected)
ARDS
CXR
Clinical findings
Hypersensitivity Pneumonitis
CXR - Fluffy nodular shadowing
CT - Reticular and nidular changes
PFT
Blood test - IgG, precipitating antibodies
Sarcoidosis
CXR CT FBC Transbronchial biopsy Serum ACE levels PFT
Idiopathic pulmonary fibrosis
CXR CT PFT Blood gases Blood tests
Pleural Effusion
CXR - blunt costophrenic angles CT - benign or malignant Ultrasound Diagnostic aspiration Biopsy
Pneumothorax
Decide if tension
CXR
Establish size
Check if patient is breathless
Pulmonary embolism
V/Q scan Doppler veins CTPA Arterial blood gases Troponin D-dimer ECG CXR
DVT
Clinical diagnosis combined with D-dimer blood test
Ultrasound
Venography
Pulmonary hypertension
CXR - enlargement of pulmonary arteries V/Q scan CTPA ECG Echo cMRI Blood tests Liver ultrasound - excludes cirrhosis PFT
Tonilitis/pharyngitis
Throat swab
Nasal swab
Blood test
Otitis Media
Examination of ear
Epiglottitis
Do not examine throat without tongue depressor!
Direct inspection using laryngoscopy
Croup
Clinical diagnosis by ruling out other conditions
Glandular Fever
Monospot test
Sinusitis/Rhinitis
If severe then refer to ENT
Acute bronchitis
Examination and clinical diagnosis
Pneumonia
FBC and serum biochemistry CXR Blood cultures Throat swab Urinary legionella antigen Sputum microscopy adn culture
Bronchiectasis
High res CT of thorax Sputum culture Serum immunoglobulins Total IgE and aspergillus perciptins CF genotyping
Lung abscess
CXR
CT
Blood culture and tests
Sputum culture
Empyema
Thoracocentesis
Aspiration of fluid under ultraosund and sent for gram stain
Exudate or transudate
Small cell carcinoma
CXR CT Fine needle aspiration Biopsy Sputum cytology Staging
Non-small cell carcinoma
CXR CT Fine needle aspiration Biopsy Sputum cytology Staging PET TNM Bronchoscopy
Cystic Fibrosis
Guthrie test Sweat test Genetic screening Full blood tests Bacteriology CXR Ultrasound Spirometry
TB
Mantoux test 3 sputum specimens on successive days CXR PCR Histology - caseating granuloma
Sleep apnoea
Overnight pulse oximetry/video recording
Polysomnography
Narcolepsy
CXR
CT
Blood culture and test
Sputum culture
