INVESTIGATIONS
RESPIRATORY CAUSE
• 1- Examination of sputum• 2- Radiology of chest• 3-Bronchoscopy• 4-Broncho alveolar lavage• 5- Lung biopsy• 5- pulmonary function tests
NON RESPIRATORY CAUSE
CVSX-Ray CT MRI ECG
GERD Barium meal
EXAMINATION OF SPUTUM
Inspection
Microscopy
microbiological Examination
1-INSPECTION Colour Smell
Quantity
• Viscid & yellow
* a/c bronchitis * Bronchiectasis * Lung abscess
• White & Mucoid
* c/c bronchitis * Bronchial Asthma * Pulmonary Tuberculosis
• Rusty sputum
* pneumonia
• Cursch-man’s spirals
Bronchial asthma Allergic bronchopulmonary aspergillosis
• Watery & blood stained sputum
* Pulmonary edema
• Blood in sputum [hemoptysis]
*TB, *Pneumonia, *Bronchiectasis, * Lung abscess, *Mitral Stenosis, *Bronchogenic carcinoma
• Chocolate coloured sputum
* Amoebiasis
Foul smell
• c/c suppuration
bronchiectasis lung abscess
2-MICROSCOPY
• Wet preparations entamoeba, paragonimus
• Wet staining wt methylene blue malignant cells
• Gram’s staining bacterial pathogens
• Ziehl – Neelsen Staining * mycobacteria 50,000/ml- sputum positive
*at least 2 bacilli
*at least 100 fields
• Papanicolaou stain
* cytological abnormalities * identify malignant cells * demonstrate bronchial casts
3-MICROBIOLOGY Culture of sputum
Drug sensitivity
RADIOLOGY OF CHEST• PA view chest investigation of choice
• Lateral viewlobar/segmental pathology
• Anterior oblique view abnormality of heart [atrial & ventricular enlargement]
TB- pulmonary nodule
Advanced b/l TUBERCULOSIS
PULMONARY MASS
LUNG CANCER
LUNG ABSCESS
Rt basal consolidation & pleural effusion
Rt upper lobe consolidation
Rt lower lobe consolidation
TOTAL LUNG COLLAPSE
MEDIASTINAL SHIFT IN PULMONARY COLLAPSE
PULMONARY FIBROSIS
Lung cavitation
CYST
Coin lesion
Cannon balls
Emphysema
PNEUMOTHORAX
Hydropneumothorax on left side
PLEURAL EFFUSION
CT SCAN
Bronchogram
• Delineate bronchial tree
bronchiectasis
intrabronchial obstruction
BRONCHOSCOPY
CARDIOMEGALY
ECG
GERD
GERD BARIUM MEAL
THANK YOU…