Diagnostic Tests for Respiratory conditions
Respiratory conditions Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Respiratory conditions:
- Lung & Respiratory Health Tests:
Respiratory conditions Diagnosis: Book Excerpts
- Ask the Following Questions - SORE THROAT
- Differential Diagnosis - Sore Throat
- Differential Diagnosis - Cough - Productive
- Differential Diagnosis - Sore Throat
- Approach to the Diagnosis - SORE THROAT
- History and physical examination - Cough, barking
- History and physical examination - Cough, productive
- Diagnosis - Acute respiratory failure in COPD
- Diagnosis - Infant respiratory distress syndrome
- Diagnosis - Respiratory syncytial virus infection
- Diagnostic tests - Introduction Respiratory Disorders
- Diagnosis - Severe acute respiratory syndrome
- History and physical examination - Cough, barking
- History and physical examination - Cough, productive
- Differential Overview - Sore Throat
- Diagnosis - Acute respiratory failure in COPD
- Diagnosis - Respiratory acidosis
- Diagnosis - Respiratory alkalosis
- Diagnosis - Respiratory distress syndrome
- Diagnosis - Respiratory syncytial virus infection
- History - Cough, barking
- History - Cough, productive
- History - Cough, barking
- History - Cough, productive
- Clinical Features and Diagnosis - Sore Throat
- Clinical Features and Diagnosis Respiratory Distress (Neonatal) - Respiratory Distress and Apnea
- History and physical examination - Cough, barking
- History and physical examination - Cough, productive
- Approach to the Diagnosis - SORE THROAT
Diagnosis of Respiratory conditions: medical news summaries:
The following medical news items
are relevant to diagnosis of Respiratory conditions:
Diagnostic Tests for Respiratory conditions: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the diagnostic tests for Respiratory conditions.
SORE THROAT:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
In a sore throat with typical exudates very suggestive of streptococcal pharyngitis, a throat culture may be all one needs before starting definitive antibiotic therapy. In the more difficult cases, screening for streptococcal antigens (streptozyme test and ASO titer) might be indicated. An ASO titer is particularly important when one suspects rheumatic fever. If the patient's streptococcal sore throat persists, a Monospot test and a culture for gonorrhea should be done. Although there are hardly any false-negative Monospot tests, there are 10% false positives, and that should be kept in mind. A blood smear for atypical lymphocytes may be helpful, as well as a heterophile antibody titer in those cases.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Cough, barking:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
Ask the child's parents when the barking cough began and what other signs and symptoms accompanied it. When did the child first appear to be ill? Has he had previous episodes of croup syndrome? Did his condition improve upon exposure to cold air?
Spasmodic croup and epiglottiditis typically occur in the middle of the night. The child with spasmodic croup has no fever, but the child with epiglottiditis has a sudden high fever. An upper respiratory tract infection typically is followed by laryngotracheobronchitis.
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Source: Handbook of Signs & Symptoms (Third Edition), 2006
Cough, productive:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
When the patient's condition permits, ask when the cough began, and find out how much sputum he's coughing up each day. (The normal tracheobronchial tree can produce up to 3 oz [89 ml] of sputum per day.) At what time of day does he cough up the most sputum? Does his sputum production have any relationship to what or when he eats or to his activities or environment? Ask him if he has noticed an increase in sputum production since his coughing began. This may result from external stimuli or from such internal causes as chronic bronchial infection or a lung abscess. Also ask about the color, odor, and consistency of the sputum. Blood-tinged or rust-colored sputum may result from trauma due to coughing or from an underlying condition, such as a pulmonary infection or a tumor. Foul-smelling sputum may result from an anaerobic infection, such as bronchitis or a lung abscess.
How does the cough sound? A hacking cough results from laryngeal involvement, whereas a “brassy” cough indicates major airway involvement. Does the patient feel pain associated with his productive cough? If so, ask about its location and severity and whether it radiates to other areas. Does coughing, changing body position, or inspiration increase or help relieve his pain?
Next, ask the patient about his cigarette, drug, and alcohol use and whether his weight or appetite has changed. Find out if he has a history of asthma, allergies, or respiratory disorders, and ask about recent illnesses, surgery, or trauma. What medications is he taking? Does he work around chemicals or respiratory irritants such as silicone?
Examine the patient's mouth and nose for congestion, drainage, or inflammation. Note his breath odor; halitosis can be a sign of pulmonary infection. Inspect his neck for distended veins, and palpate for tenderness and masses or enlarged lymph nodes. Observe his chest for accessory muscle use, retractions, and uneven chest expansion, and percuss for dullness, tympany, or flatness. Finally, auscultate for a pleural friction rub and abnormal breath sounds — rhonchi, crackles, or wheezes. (See Productive cough: Common causes and associated findings, page 168.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Introduction: Respiratory Disorders:
Assessment
(Professional Guide to Diseases (Eighth Edition))
Assessment of the respiratory system begins with a thorough patient history. Ask the patient to describe his respiratory problem. How long has he had it? How long does each attack last? Does one attack differ from another? Does any activity in particular bring on an attack or make it worse? What relieves the symptoms? Always ask whether the patient was or is a smoker, what and how often he smoked or smokes, and how long he smoked or has been smoking. Record this information in “pack years”—the number of packs of cigarettes per day multiplied by the number of smoking years. Remember to ask about the patient’s occupation, hobbies, and travel; some of these activities may involve exposure to toxic or allergenic substances.
If the patient has dyspnea, ask if it occurs during activity or at rest. What position is the patient in when dyspnea occurs? How far can he walk? How many flights of stairs can he climb? Has his exercise tolerance been decreasing? Can he relate dyspnea to allergies or environmental conditions? Does it occur only at night, during sleep? If the patient has a cough, ask about its severity, persistence, and duration; ask if it produces sputum and, if so, what kind. Have the patient’s cough habits and character of sputum changed recently?
Physical examination
Use inspection skills to check for clues to respiratory disease, beginning with the patient’s general appearance. If he’s frail or cachectic, he may have a chronic disease that has impaired his appetite. If he’s diaphoretic, restless, or irritable or protective of a painful body part, he may be in acute distress. Also, look for behavior changes that may indicate hypoxemia or hypercapnia. Confusion, lethargy, bizarre behavior, or quiet sleep from which he can’t be aroused may point to hypercapnia. Watch for marked cyanosis, indicated by bluish or ashen skin (usually best seen on the lips, tongue, earlobes, and nail beds), which may be due to hypoxemia or poor tissue perfusion.
Assess chest shape and symmetry at rest and during ventilation. Increased anteroposterior diameter (“barrel chest”) characterizes emphysema. Kyphoscoliosis also alters chest configuration, which in turn restricts breathing. Assess respiratory excursion and observe for accessory muscle use during breathing. The use of upper chest and neck muscles is normal only during physical stress.
Observe the rate and pattern of breathing because certain disorders produce characteristic changes in breathing patterns. For example, an acute respiratory disorder can produce tachypnea (rapid, shallow breathing) or hyperpnea (increased rate and depth of breathing); intracranial lesions can produce Cheyne-Stokes and Biot’s respirations; increased intracranial pressure can result in central hyperventilation and apneustic or ataxic breathing; metabolic disorders can cause Kussmaul’s respirations; and airway obstruction can lead to prolonged forceful expiration and pursed-lip breathing.
Also observe posture and carriage. A patient with COPD, for example, usually supports rib cage movement by placing his arms on the sides of a chair to increase expansion and leans forward during exhalation to help expel air.
Palpation of the chest wall detects areas of tenderness, masses, changes in fremitus (palpable vocal vibrations), or crepitus (air in subcutaneous tissues). To assess chest excursion and symmetry, place your hands in a horizontal position, bilaterally on the posterior chest, with your thumbs pressed lightly against the spine, creating folds in the skin. As the patient takes a deep breath, your thumbs should move quickly and equally away from the spine. Repeat this with your hands placed anteriorly, at the costal margins (lower lobes) and clavicles (apices). Unequal movement indicates differences in expansion, seen in atelectasis, diaphragm or chest wall muscle disease, or splinting due to pain.
Percussion should detect resonance over lung fields that aren’t covered by bony structures or the heart. A dull sound on percussion may mean consolidation or pleural disease. (See Characterizing and interpreting percussion sounds.)
Auscultation normally detects soft, vesicular breath sounds throughout most of the lung fields. Absent or adventitious breath sounds may indicate fluid in small airways or interstitial lung disease (crackles), secretions in moderate and large airways (rhonchi), and airflow obstruction (wheezes).
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cough, barking:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Ask the child’s parents when the barking cough began and what other signs and symptoms accompanied it. When did the child first appear to be ill? Has he had previous episodes of croup syndrome? Did his condition improve upon exposure to cold air?
Spasmodic croup and epiglottiditis typically occur in the middle of the night. The child with spasmodic croup has no fever, but the child with epiglottiditis has a high fever of sudden onset. An upper respiratory tract infection typically is followed by laryngotracheobronchitis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Cough, productive:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
When the patient’s condition permits, ask when the cough began and how much sputum he’s coughing up each day. (The normal tracheobronchial tree can produce up to 3 oz [89 ml] of sputum per day.) At what time of day does he cough up the most sputum? Is his sputum production affected by what or when he eats, his activities, or his environment? Ask him if he has noticed an increase in sputum production since his coughing began. This may result from external stimuli or from such internal causes as chronic bronchial infection or a lung abscess. Also ask about the color, odor, and consistency of the sputum. Blood-tinged or rust-colored sputum may result from trauma due to coughing or from an underlying condition, such as a pulmonary infection or a tumor. Foul-smelling sputum may result from an anaerobic infection, such as bronchitis or a lung abscess.
How does the cough sound? A hacking cough results from laryngeal involvement, whereas a “brassy” cough indicates major airway involvement. Does the patient feel any pain associated with his productive cough? If so, ask about its location and severity and whether it radiates to other areas. Does coughing, changing body position, or inspiration increase or help relieve his pain?
Next, ask the patient about his cigarette, drug, and alcohol use and whether his weight or appetite has changed. Find out if he has a history of asthma, allergies, or respiratory disorders, and ask about recent illnesses, surgery, or trauma. What medications is he taking? Does he work around chemicals or respiratory irritants such as silicone?
Examine the patient’s mouth and nose for congestion, drainage, or inflammation. Note his breath odor: Halitosis can be a sign of pulmonary infection. Inspect his neck for distended veins, and palpate it for tenderness, masses, and enlarged lymph nodes. Observe his chest for accessory muscle use, retractions, and uneven chest expansion, and percuss it for dullness, tympany, or flatness. Finally, auscultate for pleural friction rub and abnormal breath sounds, including rhonchi, crackles, or wheezing. (See Productive cough: Causes and associated findings, pages 206 and 207.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Sore Throat:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
The most important consideration is whether the patient has a group A strep infection because prompt treatment prevents rheumatic fever. The findings of fever, tender anterior cervical adenopathy, and tonsillar exudate can be combined to make the diagnosis more or less likely. Rapid antigen tests have a sensitivity of 80% to 90% and specificity of 95% to 100%, so give a reasonably accurate diagnosis. Because of limitations in sensitivity however, patients with a high suspicion on clinical grounds should have a backup culture taken.
Prior probability in an adult population with sore throat is 5% to 10%, and in a pediatric population 20% to 25%. A prominent sore throat out of proportion to the degree of pharyngeal inflammation should raise the possibility of acute epiglottitis and acutely impending airway compromise. Persistent unilateral tonsillar enlargement in a young adult without sore throat should raise the suspicion of lymphoma.
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Source: Field Guide to Bedside Diagnosis, 2007
Cough, barking:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Observe the child for signs of respiratory distress. Note use of sternal or intercostal retractions or nasal flaring. Observe his skin for cyanosis and diaphoresis. Take his vital signs, noting respiratory rate and depth. Although stridor can be heard without a stethoscope, auscultate his lungs. Decreased breath sounds and crackles may be present.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Cough, productive:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Examine the patient’s mouth and nose for congestion, drainage, or inflammation. Note his breath odor: Halitosis can be a sign of pulmonary infection. Inspect his neck for distended veins, and palpate for tenderness and masses or enlarged lymph nodes. Observe his chest for accessory muscle use, retractions, and uneven chest expansion, and percuss for dullness, tympany, or flatness. Finally, auscultate for pleural friction rub and abnormal breath sounds — rhonchi, crackles, or wheezes.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Sore Throat:
Diagnostic Approach
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
Historyand physical exam provide important clues for proper diagnosis ofsore throat.Most common clinical dilemma in childwith pharyngitis is whether pathogen is virus or group A Streptococcus.Tests to detect streptococcal antigen may be diagnostic, but ifresults of such tests are negative, throat culture should be performed.Because many cases of pharyngitis aredue to viruses, antibiotic use should be guided by antigen detectiontests or culture. Presence of conjunctivitis, cough, rhinitis, andhoarseness suggests viral etiology. Infectious mononucleosis isalso a consideration, especially in older children and adolescents.Neck radiography, flexible laryngoscopy,and CT are useful with suspected foreign body or retropharyngeal/lateralpharyngeal abscess.
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Respiratory Distress and Apnea:
Diagnostic Approach: Respiratory Distress
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
In preterminfants, most common cause of respiratory distress is respiratorydistress syndrome. In term infants, transient tachypnea, meconiumaspiration, pneumonia, and pneumothorax are most common lower respiratorytract disorders causing respiratory distress. Other nonpulmonarycauses of respiratory distress in neonates are congenital heartdisease, persistent fetal circulation, and septicemia. In infancyand childhood, most common causes of respiratory distress are bronchiolitis,croup, asthma, pneumonia, foreign body aspiration, and congenitalor acquired heart disease with cardiac failure.History and physical exam suggest mostlikely cause for respiratory distress. Oxygen saturation in roomair indicates degree of hypoxemia. Certain tests should be considereddepending on clinical circumstances:Airway radiography or endoscopy for upperairway obstructionChest radiography for lower respiratorydisorders or cardiac diseaseCBC for anemiaSerum electrolytes and creatinine;blood urea nitrogen; and venous/capillary pH for metabolicacidosisECG and 2-D echocardiography for cardiacfailureChest CT for any airway, lung, or mediastinal mass
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Cough, barking:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
Ask the child's parents when the barking cough began and what other signs and symptoms accompanied it. When did the child first appear to be ill? Has he had previous episodes of croup syndrome? Did his condition improve upon exposure to cold air?
Spasmodic croup and epiglottiditis typically occur in the middle of the night. The child with spasmodic croup has no fever, but the child with epiglottiditis has a sudden high fever. An upper respiratory tract infection typically is followed by laryngotracheobronchitis.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Cough, productive:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
When the patient's condition permits, ask when the cough began, and find out how much sputum he's coughing up each day. (The normal tracheobronchial tree can produce up to 3 oz [89 ml] of sputum per day.) At what time of day does he cough up the most sputum? Does his sputum production have any relationship to what or when he eats or to his activities or environment? Ask him if he has noticed an increase in sputum production since his coughing began. This may result from external stimuli or from such internal causes as chronic bronchial infection or a lung abscess. Also ask about the color, odor, and consistency of the sputum. Blood-tinged or rust-colored sputum may result from trauma due to coughing or from an underlying condition, such as a pulmonary infection or a tumor. Foul-smelling sputum may result from an anaerobic infection, such as bronchitis or a lung abscess.
How does the cough sound? A hacking cough results from laryngeal involvement, whereas a “brassy” cough indicates major airway involvement. Does the patient feel pain associated with his productive cough? If so, ask about its location and severity and whether it radiates to other areas. Does coughing, changing body position, or inspiration increase or help relieve his pain?
Next, ask the patient about his cigarette, drug, and alcohol use and whether his weight or appetite has changed. Find out if he has a history of asthma, allergies, or respiratory disorders, and ask about recent illnesses, surgery, or trauma. What medications is he taking? Does he work around chemicals or respiratory irritants such as silicone?
Examine the patient's mouth and nose for congestion, drainage, or inflammation. Note his breath odor; halitosis can be a sign of pulmonary infection. Inspect his neck for distended veins, and palpate for tenderness and masses or enlarged lymph nodes. Observe his chest for accessory muscle use, retractions, and uneven chest expansion, and percuss for dullness, tympany, or flatness. Finally, auscultate for a pleural friction rub and abnormal breath sounds—rhonchi, crackles, or wheezes.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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