chronic nonproductive cough flutter device

Therefore, COPD patients show distress especially in acute phase. In terms of physical examination, general appearance is crucial. On the contrary, chronic bronchitis patients are more obese, and report, less dyspnea and more hypoxemia (Table 2). Emphysema dominant type have thin and more dyspnea with preserved arterial blood gas value. The meaning of classifying these two types are different clinical presentation. In phenotype of COPD, I divide into emphysema dominant type or chronic bronchitis. In social history, smoking and occupation are essential. On history taking, most important symptoms are progressive exertional dyspnea and cough. Second, we show approach for obstructive disease such as bronchial asthma and chronic obstructive pulmonary disease (COPD).

After using antibiotics, decrease trajectory of inflammatory markers usually means clinical success. However, distinction of bacterial infection and non-bacterial infection such as viral infection is moderate. Recently,utility of procalcitonin (PCT) have been reported. Both inflammatory markers with vital signs and physical findings have positive relationship. In laboratory findings, WBC and CRP are main items. With echo, I recommend thoracocentesis if free fluid is over 2 cm and fibrin like material within fluid suggest empyema. When we see patients who has persistent fever with adequate antibiotics, one of the differential diagnosis is para-pneumonic effusion. It clarifies definite pleural effusion with internal structure. Regarding physiology of respiratory infection, chest echo is recent useful tool. Extra-pulmonary symptoms such as joint pain, muscle ache and rash reminds us about mycoplasma and viral infection. On the other hand, if we hear late inspiratory crackles, we usually consider atypical agent such as mycoplasma, legionella or viral pneumonia. When we hear pan-inspiratory crackles, our priority diagnosis is typical pneumonia with non segmental distribution such as pneumococcal pneumonia and Klebsiella pneumonia. Lung auscultation provide useful information for physician. In terms of physical examination, oral hygiene contribute to respiratory infection especially anaerobic infection such as aspiration pneumonia, lung abscess and empyema. If we see chronic pneumonia, important differential diagnosis are tuberculosis, lung abscess and actinomycosis. Subacute community acquired pneumonia are Hemophilus influenzae, Moraxella catarrhalis and mycoplasma pneumonia (Table 1). For example, representative acute pneumonia are pneumococcus, Klebsiella, Legionella, influenza virus and aspiration pneumonia. These clinical scenario is associated with likely infection. I divide into three courses such as acute, subacute and chronic. In history taking, clinical course is most crucial. I describe practical approach for common respiratory diseases using clinical findings and physiological data.įirst, I show approach for community acquired pneumonia. However, there are scarce reports about integration of clinical information and physiological findings. Journal of Respiratory Research 2015 1(1): 1-4 Available from: URL: įVC: forced vital capacity DLco: Diffusing capacity of the lung for carbon monoxide 6MWTD: 6 minute walking test distance 6MWTD mMRC: modified Medical Research Council.ĭiagnosis and management of respiratory disease is based on detailed history, physical examination and physiology. Integration of Clinical Findings and Physiology in Respiratory Disease. Key words:Integration, detailed history, physical findings, physiology, dyspnea I show integrated approach of clinical findings and physiology for representative respiratory diseases such as community acquired pneumonia, chronic obstructive lung disease, bronchial asthma and interstitial lung disease. Using focused clinical approach and physiological thinking will contribute to arrive adequate diagnosis with imaging and pathology. In approach for these diseases, we should collect many useful clinical information with physiological, imaging, and pathological point of view. Respiratory diseases have broad category from allergic disease to diffuse lung diseases.

Chronic nonproductive cough flutter device