Differential Diagnoses

Front 1

Increased Tactile Fremitus

Back 1

Consolidation of alveoli--> transmission of vocal vibration increases as opposed to alveoli filled with air

Also with consolidation--> dullness to percussion

Front 2

Decreased Tactile Fremitus

Back 2

Pleural Efusion

Obstructive Lung Disease (normal to decreased)

Front 3

Crackles

Back 3

Consolidation - Inflammatory exudate present in bronchioles and/or alveoli

Front 4

Purulent Sputum (coughing up exudate in small bronchiles)

Back 4

Bacterial Pneumonia

Front 5

DDx of Interstitial Lung Diseases

Back 5

-Cardiovascular: pulmonary edema

-Aspirational: GERD, hemoptysis, lipoid pneumonia

-Certain “Airway Diseases”: CF, bronchiectasis, acute bronchiolitis

-Trauma

-Idiopathic: cirrhosis, amyloidosis, histiocytosis X, etc.

Front 6

DDx of Idiopathic Interstitial Pneumonia

Back 6

1) IPF; UIP; Cryptogenic Fibrosing Alveolitis---> Features: Middle Age; Progressive; Honeycombing
Steroid Responsive: No

2) Desquamative Interstial Pneumonitis--> Features: Smokers; Pigmented Mac’s in Alveolar Spaces
Steroid Responsive? Yes
3) Acute Interstial Pneumonitis--> Features: Progression in weeks
to months
Steroid Responsive? No

4) Nonspecific Interstitial Pneumonitis--> Features: Young Patients (<55y.o.); Associated with Collagen Vascular Diseases
Steroid Responsive? Yes

5) Respiratory Bronchiolitis with Interstial Disease--> Features: Smokers; May resolve with smoking cessation
Steroid Responsive? Yes
6) BOOP Nonspecific tissue repair reaction--> Features Intraluminal plugs of connective tissue in bronchioles, alveolar ducts
Steroid Responsive? Yes

Front 7

What is idiopathic Pulmonary Fibrosis?

How is pulmonary function affected?

Back 7

Pulmonary disease of unknown cause, characterized by parenchymal inflammation (Alveolitis) and progressive interstitial fibrosis

Pulmonary functions – Restriction and decreased diffusing capacity for carbon monoxide