Efficacy and continued technical improvements in CT pulmonary angiography (CTPA) have produced a significant rise in its use for the diagnosis of acute pulmonary embolism (PE). The growth of CTPA has produced a corresponding reduction in the utilization of pulmonary scintigraphy to the extent that some publications have suggested that lung scanning has become a second-line test. Lung ventilation/perfusion (V/Q) scintigraphy along with modified prospective investigation of pulmonary embolism diagnosis (PIOPED) interpretation criteria has been utilized to diagnose acute PE. More recently, a simplified algorithm comprising pulmonary perfusion scan along with prospective investigative study of pulmonary embolism diagnosis (PISAPED) interpretation criteria has shown a reduction of intermediate probability as one of the lung scan readings generated by the modified PIOPED criteria and has improved the sensitivity and specificity of the lung scintigraphy along with the modified PIOPED criteria to detect acute PE. Continue reading “PIOPED II, PISAPED and CTPA Criteria for Diagnosis of Pulmonary Embolus”
The pulmonary embolism rule-out criteria (PERC) was designed to identify patients in whom the risk of testing outweighs the benefits (the “test threshold”, which for pulmonary embolism (PE) was calculated as a 2% prevalence). Continue reading “Pulmonary Embolism Rule-out Criteria (PERC)”
In 2000, IPF was defined as a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown cause, occurring primarily in older adults and limited to the lungs. Usual interstitial pneumonia (UIP) is the histopathological pattern of IPF. IPF is characterized by progressive worsening of dyspnea and lung function and is associated with a poor prognosis. Continue reading “Diagnostic Criteria for Idiopathic Pulmonary Fibrosis (IPF)”
Obstructive sleep apnea syndrome (OSAS) is defined as repeated episodes of obstructive apneas and hypopneas during sleep, frequently followed by transient hemoglobin desaturation (hypoxemia) and unconscious (EEG) arousals.
Continue reading “Diagnosis of Obstructive Sleep Apnea (OSA) in Adults and Children”
In current hospital practice chest drains are used in many different clinical settings and doctors in most specialities need to be capable of their safe insertion. Continue reading “Indications and Contraindications for Tube Thoracostomy”
The Wells Clinical Prediction Rule is a diagnostic tool used during review of systems to identify possible pulmonary embolism (PE) and deep vein thrombosis (DVT). Continue reading “Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis”
- Diagnosis of sarcoidosis is firm when chest radiographic evidence is accompanied by compatible clinical features and noncaseating granulomas on biopsy, with all other causes of granulomas ruled out.
- Biopsy is indicated for all patients presumed to have sarcoidosis, except those with Löfgren’s syndrome.
Continue reading “Diagnosis, Clinical Characteristics, and Treatment of Sarcoidosis”
Criteria for Chronic Respiratory Failure due to Cardiopulmonary Disorders in Infants and Children
- Decreased inspiratory breath sounds
- Increased retractions, use of accessory muscles
- Cyanosis breathing room air
- Decreased level of normal activity/function
- Poor weight gain (mass) (IMPORTANT)
Continue reading “Criteria for Chronic Respiratory Failure in Infants and Children”
CURB and CRB-65 scores can be used in the hospital and out-patients setting to assess pneumonia severity and the risk of death.
Continue reading “CURB-65 and CRB-65 Severity Scores for Community-Acquired Pneumonia (CAP)”
The Tumor, Node, Metastasis (TNM) staging system for lung cancer is an internationally accepted system used to characterize the extent of disease. The TNM system combines features of the tumor into disease stage groups that correlate with survival and are linked to recommendations for treatment.
Continue reading “Tumor, Node, Metastasis International Staging System for Lung Cancer”