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Diagnostic Evaluation of the Respiratory System Claudio Sorino

SECTION 1: RESPIRATORY SYSTEM ASSESSMENT
CHAPTER 1:Signs, Symptoms, and Medical History in Respiratory Medicine
- HISTORY OF PRESENT ILLNESS (HPI)
- PAST MEDICAL HISTORY (PMH)
- DRUG HISTORY (DH)
- FAMILY HISTORY
- OCCUPATIONAL HISTORY (OH)
- DYSPNEA
  - Pathophysiology of Dyspnea
  - Measurement Tools for Dyspnea
- CHEST PAIN
- COUGH
- HEMOPTYSIS (COUGHING UP BLOOD)
- MISCELLANEOUS SYMPTOMS
CHAPTER 2:Respiratory Examination
- OVERVIEW OF THE SEMEIOTICS OF THE RESPIRATORY SYSTEM
- CHEST INSPECTION
- CHEST PALPATION
- CHEST PERCUSSION
- CHEST AUSCULTATION
CHAPTER 3:Clinical Utility and Interpretation of Laboratory Tests in Respiratory Medicine
- OVERVIEW OF LABORATORY TESTS IN RESPIRATORY MEDICINE
- BLOOD COUNT
- C-REACTIVE PROTEIN
- ERYTHROCYTE SEDIMENTATION RATE
- PROCALCITONIN
- LABORATORY DIAGNOSIS OF PNEUMONIA
  - Microbiology
  - Serology and Urine Antigens
- D-DIMER
- NATRIURETIC PEPTIDES
  - Role in Diagnosis of Acute Dyspnea
- MARKERS FOR MYOCARDIAL ISCHEMIA
- TUMOR MARKERS IN LUNG CANCER
CHAPTER 4:Diagnosis of Respiratory Allergy
- OVERVIEW OF ALLERGY DIAGNOSIS
- IN VIVO (SKIN) TESTS FOR CONFIRMATION OF ALLERGIC SENSITIZATION
  - Precautions and Contraindications
  - Skin Prick Testing Procedure
- IN VITRO (SEROLOGICAL) TESTS FOR ALLERGIC SENSITIZATION
- MOLECULAR-BASED ALLERGY
  - Method
  - Clinical Use
- DEFINITIONS
CHAPTER 5:Tuberculosis Diagnostics: In Vivo and In Vitro Techniques
- BACKGROUND
- DIAGNOSIS OF LATENT TUBERCULOSIS INFECTION
- DIAGNOSIS OF ACTIVE PULMONARY TUBERCULOSIS
SECTION 2: EVALUATION OF RESPIRATORY FUNCTION
CHAPTER 6:Overview of the Pulmonary Function Tests
- MEANING OF LUNG FUNCTION
- SPIROGRAM AND DISPLACEABLE VOLUMES
- NONDISPLACEABLE LUNG VOLUMES
- PARAMETERS OF RESPIRATORY FLOW
- PARAMETERS OF AIRWAYS RESISTANCE
- PARAMETERS OF LUNG DIFFUSING CAPACITY
  - Tools Used for the Measurement of Lung Function
    - Spirometry
CHAPTER 7:Displaceable Lung Volumes: Simple Spirometry
- OVERVIEW OF SIMPLE SPIROMETRY
- PREPARATION OF THE EQUIPMENT
- PREPARATION OF THE PATIENT AND PRECAUTIONS BEFORE TESTING
- TEST EXECUTION
- QUALITY ASSESSMENT OF SPIROMETRY
- INTERPRETATION OF TEST
- BRONCHODILATOR REVERSIBILITY TEST
CHAPTER 8:Lung Volumes and Further Assessment: Beyond Spirometry
- HISTORY OF LUNG VOLUME MEASUREMENT
- DEFINITIONS
- CLINICAL VALUE OF LUNG VOLUME MEASUREMENTS
- BODY PLETHYSMOGRAPHY
- HELIUM DILUTION
  - Equipment
  - Measurement Technique
- MULTIPLE-BREATH NITROGEN WASHOUT
  - Equipment
  - Measurement Technique
- IMAGING
- EVALUATION OF THE RESPIRATORY MUSCLE STRENGTH
CHAPTER 9:Bronchoprovocation Challenge Test
- OVERVIEW OF BRONCHOPROVOCATION CHALLENGE TEST AND CLINICAL INDICATIONS
- BRONCHIAL HYPERRESPONSIVENESS
- SPECIFIC AND NONSPECIFIC AIRWAY RESPONSIVENESS
- HOW TO EXPRESS AIRWAY RESPONSIVENESS?
- HOW TO PERFORM A BRONCHOPROVOCATION CHALLENGE TEST?
- CONTRAINDICATIONS AND PRECAUTIONS
- PHARMACOLOGIC CHALLENGE TESTS
- EXERCISE CHALLENGE TEST
  - Bicycle Ergometer Protocol
  - Treadmill Protocol
- COLD AIR CHALLENGE TEST
- EUCAPNIC VOLUNTARY HYPERPNEA
  - First Protocol
  - Second Protocol
- ANTIGEN CHALLENGE TEST
CHAPTER 10:Diffusing Capacity or Transfer Factor of the Lung
- PATHOPHYSIOLOGY OF PULMONARY DIFFUSION
- ALTERATIONS OF LUNG DIFFUSION CAPACITY
- OVERVIEW OF LUNG DIFFUSION MEASUREMENT
- ADVANTAGES OF USING CARBON MONOXIDE
- PATIENT PREPARATION
- PROCEDURE
- ACCEPTABILITY AND REPEATABILITY
  - Acceptability
  - Repeatability
- INTERPRETATION OF DATA
CHAPTER 11:Ventilation Homogeneity and Lung Elasticity
- LUNG VENTILATION
- LUNG ELASTICITY: STATICS
- LUNG ELASTICITY: DYNAMICS
- PHYSIOLOGICAL METHODS TO STUDY THE DISTRIBUTION OF VENTILATION
CHAPTER 12:Lung Function Testing in Preschool Children
- OVERVIEW OF LUNG FUNCTION TESTING IN PRESCHOOL CHILDREN
- INTERRUPTER TECHNIQUE
- FORCED OSCILLATION TECHNIQUE
- SPIROMETRY IN COOPERATING CHILDREN
- PRESCHOOL SPIROMETRY
  - Types of Ventilatory Defects
- EXHALED NITRIC OXIDE
- EXHALED BREATH CONDENSATE
- STATIC LUNG VOLUMES
- BRONCHOPROVOCATION CHALLENGE TEST
CHAPTER 13:Arterial Blood Gas Analysis and other Tools for the Evaluation of Gas Exchange Efficiency
- OVERVIEW OF THE MEASUREMENT OF GAS EXCHANGE EFFICIENCY
- PULSE OXIMETRY
- TRANSCUTANEOUS OXYGEN AND CARBON DIOXIDE MEASUREMENT
CHAPTER 14:Cardiopulmonary Exercise Testing
- OVERVIEW OF CARDIOPULMONARY EXERCISE TESTING AND MAIN INDICATIONS
- EQUIPMENT REQUIRED
- PRETEST RECOMMENDATIONS
- TEST PROTOCOLS
- CPET PROCEDURE
- KEY VARIABLES, NORMAL VALUES AND SIGNIFICANCE
- ANAEROBIC, LACTATE, AND VENTILATORY THRESHOLDS
- INTERPRETATION OF RESULTS
- REPORT PREPARATION
CHAPTER 15:Diagnostic Tests for Sleep-Related Breathing Disorders
- SLEEP VERSUS WAKEFULNESS: WHAT IS DIFFERENT?
- OVERVIEW OF SLEEP-RELATED BREATHING DISORDERS
  - Central Sleep Apnea Syndrome and Cheyne-Stokes Respiration
- TESTS FOR MEASURING EXCESSIVE DAYTIME SLEEPINESS
- HOW TO STUDY SLEEP?
- HOW TO SELECT THE MOST APPROPRIATE DIAGNOSTIC PROCEDURE?
- PREPARATION OF THE PATIENT FOR POLYGRAPHY
- ANALYSIS AND INTERPRETATIVE STRATEGIES
- FACTORS TO BE INCLUDED IN A SUMMARY REPORT
- DIAGNOSTIC CRITERIA FOR RESPIRATORY EVENTS
SECTION 3: DIAGNOSTIC IMAGING
CHAPTER 16:Chest Radiograph: Technical Aspects, Normal Findings and Extrapulmonary Structures
- OVERVIEW
- NOTES ON TECHNICAL ASPECTS
- NORMAL LUNG AND LUNG PARENCHYMA
- TRACHEA AND CENTRAL AIRWAYS
- PLEURA
- MEDIASTINUM
- CHEST WALL
  - Review Areas
- CONCLUSION
CHAPTER 17:Chest Radiograph: Lung Pathological Findings and Main Signs
- OVERVIEW
- DECREASED PULMONARY DENSITY
- MAIN SIGNS IN RADIOLOGY
CHAPTER 18:Chest Computed Tomography for the Evaluation of Respiratory Diseases
- INTRODUCTION
- EVOLUTION OF CT AND APPLICATIONS TO THE RESPIRATORY TRACT
- MAIN INDICATIONS
- APPLICATIONS TO LUNG CANCER
- APPLICATIONS TO DIFFUSE PARENCHYMAL LUNG DISEASES
  - HRCT Features of UIP Pattern
- PATTERN OF INCREASED PULMONARY DENSITY
- PATTERN OF DECREASED PULMONARY DENSITY
  - Emphysema
  - Bronchiectasis
- VIRTUAL BRONCHOSCOPY
CHAPTER 19:High-Resolution Computed Tomography for the Evaluation of Airways Distensibility
- AIRWAY DISTENSION AND DEEP INSPIRATIONS
- BENEFICIAL EFFECTS OF LUNG INFLATION
- FACTORS AFFECTING THE BENEFICIAL EFFECTS OF LUNG INFLATION
- ROLE OF HRCT IN ASSESSING AIRWAY DISTENSIBILITY
CHAPTER 20:Computed Tomographic Pulmonary Angiography
- OVERVIEW ON COMPUTED TOMOGRAPHIC PULMONARY ANGIOGRAPHY
- INDICATIONS AND CONTRAINDICATIONS
- HOW THE TEST IS PERFORMED?
CHAPTER 21:Conventional Pulmonary Angiography
- OVERVIEW OF PULMONARY ANGIOGRAPHY
- INDICATIONS
- CONTRAINDICATIONS
- RISKS AND POSSIBLE COMPLICATIONS
- TECHNIQUE
CHAPTER 22:Role of Magnetic Resonance Imaging in the Evaluation of Respiratory Diseases
- OVERVIEW AND HISTORY
- LUNG PARENCHYMA: THE BLACK HOLE OF MRI
- IS THERE ADDED-VALUE OF MRI FOR PATIENT ASSESSMENT?
- WHEN IS PULMONARY MRI THE MODALITY OF CHOICE?
  - Longitudinal and Serial Studies
  - MRI of Pediatric Lung Disease
- SUMMARY AND FUTURE DIRECTIONS
CHAPTER 23:Lung Ultrasonography
- OVERVIEW OF LUNG ULTRASOUND
- BASIC KNOWLEDGE OF LUNG ULTRASONOGRAPHY TECHNIQUE
- ULTRASOUND EQUIPMENT AND PROBES
- IMAGING OF THE CHEST WALL
- A LINES AND B LINES
- EVALUATION OF PLEURAL DISEASE
- STUDY OF DIAPHRAGMATIC KINETICS
- EVALUATION OF PULMONARY DISEASE
- ULTRASOUND-GUIDED INTERVENTIONAL PROCEDURES
CHAPTER 24:Single Photon Emission Computed Tomography in the Evaluation of Lung Diseases
- OVERVIEW OF VENTILATION/ PERFUSION SPECT
- V/P SPECT AND PULMONARY EMBOLISM
- BASIC PRINCIPLES OF PULMONARY EMBOLISM DIAGNOSIS WITH V/P SPECT
- IMAGING PROTOCOLS
  - V/P SPECT Acquisition
- REPORTING FINDINGS
- ROLE OF VENTILATION SPECT IN DIAGNOSIS OF OTHER LUNG DISEASES
- V/P SPECT VERSUS MDCT
- CLINICAL USE OF HYBRID V/P SPECT/CT
- CONCLUSION
CHAPTER 25:Positron Emission Tomography: Role in Lung Cancer Evaluation and Management
- OVERVIEW
- ROLE OF PET IN DIAGNOSIS AND STAGING OF LUNG CANCER
- ROLE OF PET IN PROGNOSIS OF LUNG CANCER
- ROLE OF PET IN CHEMOTHERAPY
- ROLE OF PET IN RADIOTHERAPY
SECTION 4: INVASIVE DIAGNOSTIC PROCEDURES
CHAPTER 26:Diagnostic Applications of Flexible Bronchoscopy
- BACKGROUND
- EQUIPMENT AND ADVANCES IN BRONCHOSCOPY
- INDICATIONS FOR DIAGNOSTIC BRONCHOSCOPY (BOX 26.1)
- CONTRAINDICATIONS TO FLEXIBLE BRONCHOSCOPY (BOX 26.2)
- TECHNIQUE
- POSITIONING AND ROUTES OF ACCESS
- PREPARATION
- SEDATION
- ANATOMY OF AIRWAYS
- PROCEDURES
- RISKS AND COMPLICATIONS
- CLEANING AND REPROCESSING FLEXIBLE BRONCHOSCOPES
CHAPTER 27:Bronchial Brushing and Biopsy
- BRONCHIAL BRUSHING
  - Procedure
  - Smear Preparation
- ENDOBRONCHIAL BIOPSY
  - Procedure
- TRANSBRONCHIAL BIOPSY
- BRONCHIAL WASHING
CHAPTER 28:Transthoracic Needle Biopsy
- OVERVIEW
- INDICATIONS AND CONTRAINDICATIONS
- BIOPSY PLANNING
- NEEDLE TYPES
- PREBIOPSY PREPARATION AND GENERAL BIOPSY TECHNIQUE
- BIOPSY TECHNIQUE FOR PULMONARY, MEDIASTINAL, AND PLEURAL LESIONS
- POSTPROCEDURAL PRECAUTIONS
- POSSIBLE COMPLICATIONS
CHAPTER 29:Conventional Transbronchial Needle Aspiration
- OVERVIEW OF TRANSBRONCHIAL NEEDLE ASPIRATION AND MAIN INDICATIONS
- PLANNING OF C-TBNA AND CHEST IMAGING STUDY
- MAPPING SYSTEMS OF THE LYMPH NODES
- REQUIRED TOOLS
- TECHNIQUE
- CONTRAINDICATIONS AND POSSIBLE COMPLICATIONS
- DIAGNOSTIC YIELD OF TRANSBRONCHIAL NEEDLE ASPIRATION
- ENDOBRONCHIAL NEEDLE ASPIRATION
- PERIPHERAL TRANSBRONCHIAL NEEDLE ASPIRATION
CHAPTER 30:Bronchoalveolar Lavage
- OVERVIEW ON BRONCHOALVEOLAR LAVAGE
- GENERAL RECOMMENDATIONS
- POSSIBLE COMPLICATIONS
- SAFETY CONSIDERATIONS
- MACROSCOPIC EXAMINATION OF BAL
- CYTOLOGICAL EXAMINATION FROM BAL
- MICROBIOLOGY FROM BAL
- EVOLVING AND FUTURE USES OF BAL FOR PATIENT MANAGEMENT AND CLINICAL RESEARCH
CHAPTER 31:Thoracentesis
- OVERVIEW OF PLEURAL EFFUSION AND THORACENTESIS
- INDICATIONS
- RELATIVE CONTRAINDICATIONS
- PATIENT PREPARATION AND POSITION
- PREPROCEDURE PLANNING
- HOW THE TEST IS PERFORMED
- RISKS AND POSSIBLE COMPLICATIONS
- POST-PROCEDURE CARE
- INTERPRETATION OF PLEURAL FLUID ANALYSIS
CHAPTER 32:Mediastinoscopy
- OVERVIEW OF MEDIASTINOSCOPY
- MAIN INDICATIONS
- SURGICAL TECHNIQUE
- RISKS AND POSSIBLE COMPLICATIONS
- DISCUSSION
CHAPTER 33:Video-Assisted Thoracic Surgery as a Diagnostic Tool
- BACKGROUND
- INDICATIONS AND CONTRAINDICATIONS
- PROCEDURE
CHAPTER 34:Endobronchial Ultrasound
- OVERVIEW OF ENDOBRONCHIAL ULTRASOUND
- TECHNOLOGY
- INDICATIONS
- TECHNIQUE
- MEDIASTINAL AND HILAR LYMPH NODES
- EBUS AND LUNG CANCER
- POSSIBLE COMPLICATIONS

INDEX

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Chapter Notes