cough investigations

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INVESTIGATIONS

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Page 1: Cough investigations

INVESTIGATIONS

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RESPIRATORY CAUSE

• 1- Examination of sputum• 2- Radiology of chest• 3-Bronchoscopy• 4-Broncho alveolar lavage• 5- Lung biopsy• 5- pulmonary function tests

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NON RESPIRATORY CAUSE

CVSX-Ray CT MRI ECG

GERD Barium meal

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EXAMINATION OF SPUTUM

Inspection

Microscopy

microbiological Examination

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1-INSPECTION Colour Smell

Quantity

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• Viscid & yellow

* a/c bronchitis * Bronchiectasis * Lung abscess

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• White & Mucoid

* c/c bronchitis * Bronchial Asthma * Pulmonary Tuberculosis

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• Rusty sputum

* pneumonia

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• Cursch-man’s spirals

Bronchial asthma Allergic bronchopulmonary aspergillosis

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• Watery & blood stained sputum

* Pulmonary edema

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• Blood in sputum [hemoptysis]

*TB, *Pneumonia, *Bronchiectasis, * Lung abscess, *Mitral Stenosis, *Bronchogenic carcinoma

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• Chocolate coloured sputum

* Amoebiasis

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Foul smell

• c/c suppuration

bronchiectasis lung abscess

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2-MICROSCOPY

• Wet preparations entamoeba, paragonimus

• Wet staining wt methylene blue malignant cells

• Gram’s staining bacterial pathogens

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• Ziehl – Neelsen Staining * mycobacteria 50,000/ml- sputum positive

*at least 2 bacilli

*at least 100 fields

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• Papanicolaou stain

* cytological abnormalities * identify malignant cells * demonstrate bronchial casts

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3-MICROBIOLOGY Culture of sputum

Drug sensitivity

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RADIOLOGY OF CHEST• PA view chest investigation of choice

• Lateral viewlobar/segmental pathology

• Anterior oblique view abnormality of heart [atrial & ventricular enlargement]

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TB- pulmonary nodule

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Advanced b/l TUBERCULOSIS

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PULMONARY MASS

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LUNG CANCER

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LUNG ABSCESS

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Rt basal consolidation & pleural effusion

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Rt upper lobe consolidation

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Rt lower lobe consolidation

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TOTAL LUNG COLLAPSE

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MEDIASTINAL SHIFT IN PULMONARY COLLAPSE

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PULMONARY FIBROSIS

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Lung cavitation

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CYST

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Coin lesion

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Cannon balls

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Emphysema

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PNEUMOTHORAX

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Hydropneumothorax on left side

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PLEURAL EFFUSION

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CT SCAN

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Bronchogram

• Delineate bronchial tree

bronchiectasis

intrabronchial obstruction

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BRONCHOSCOPY

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CARDIOMEGALY

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ECG

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GERD

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GERD BARIUM MEAL

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THANK YOU…