Cough investigations

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…