Pulmão

A ausculta dos sons respiratórios com um cilindro (estetoscópio) produz sinais auditivos facilmente interpretados, capazes de indicar a presença e a extensão da maioria dos órgãos da cavidade torácica.
René Laennec (1781-1826)

Propedêutica

Fit My Video Tag
Fit My Video Tag
Fit My Video Tag
Fit My Video Tag
Fit My Video Tag

Semiologia

Fit My Video Tag
Fit My Video Tag
Fit My Video Tag
Fit My Video Tag

Complementação

Fit My Video Tag
Fit My Video Tag
Fit My Video Tag

Perguntas

Fit My Video Tag

Perguntas

Fit My Video Tag

Perguntas

Fit My Video Tag

Perguntas

Sintomas

Fit My Video Tag
Fit My Video Tag
Fit My Video Tag
Fit My Video Tag

Dx Diferenciais

    Tosse Aguda
    • Viral URI or postviral cough (most common)
    • Bacterial URI
    • Postnasal drip (allergic rhinitis)
    • Pneumonia
    • Pulmonary edema, e.g., CHF
    • Asthma
    • Pulmonary embolism
    • Aspiration pneumonia
    Tosse crônica
    Top 3 causes: postnasal drip, asthma, gastroesophageal reflux disease (GERD)

    Don’t miss
    • Pertussis

    Pulmonary infectious
    • Postviral
    • Bronchitis, especially in smokers
    • Bronchiectasis
    • Tuberculosis
    • Cystic fibrosis
    • Mycobacterium avium complex (MAC)
    • Pertussis
    • Mycoplasma
    • Chlamydia
    • Respiratory syncytial virus (RSV)
    • Parasites, eg, ascariasis, paragonimiasis

    Pulmonary noninfectious
    • Asthma (cough-variant asthma)
    • Beta-blockers causing asthma
    • Chronic obstructive pulmonary disease (COPD)
    • ACE inhibitors
    • Irritant inhalation, eg, smoking
    • Endobronchial lesion, eg, tumor
    • Interstitial lung disease
    • Sarcoidosis
    • Chronic microaspiration

    Nonpulmonary
    • Gastroesophageal reflux disease (GERD)
    • Postnasal drip (allergic rhinitis)
    • Sinusitis
    • Congestive heart failure (CHF)
    • Laryngitis
    • Ear canal or tympanic membrane irritation
    • Psychogenic or habit cough
    Hemoptise
    Airways
    • Bronchitis
    • Bronchiectasis
    • Bronchogenic carcinoma

    Pulmonary vasculature
    • Left ventricular failure
    • Mitral stenosis
    • Pulmonary embolism
    • Arteriovenous malformation

    Pulmonary parenchyma
    • Pneumonia
    • Abscess
    • Tuberculosis
    • Aspergilloma
    • Parasites, eg, paragonimiasis, ascariasis, hookworm, strongyloidiasis
    • Goodpasture’s syndrome
    • Wegener’s granulomatosis
    • Systemic lupus erythematosus (SLE)
    • Crack cocaine inhalation
    • Idiopathic pulmonary hemosiderosis
    • Leukemia

    Iatrogenic
    • Transbronchial lung biopsy
    • Anticoagulation
    • Pulmonary artery rupture by PA line
    Sibilos
    • Asthma
    • Chronic obstructive pulmonary disease
    • Congestive heart failure (cardiac asthma)
    • Acute bronchitis
    • Pneumonia
    • Gastroesophageal reflux disease
    • Airway obstruction (eg, tumor, goiter)
    • Foreign-body aspiration
    • Aspiration pneumonia
    • Interstitial lung disease
    • Pulmonary embolism
    • Angioedema or anaphylaxis
    • Carcinoid syndrome
    • Vocal cord dysfunction
    • Ascariasis
    Dor torácica
    Don’t miss
    • Myocardial ischemia, pericarditis, aortic dissection, pulmonary embolism, tension pneumothorax, esophageal rupture

    Cardiovascular
    • Myocardial ischemia (angina, myocardial infarction), pericarditis, aortic stenosis, aortic dissection, pulmonary embolism, cardiomyopathy, myocarditis, mitral valve prolapse, pulmonary hypertension, hypertrophic obstructive cardiomyopathy (HOCM), carditis (eg, acute rheumatic fever), aortic insufficiency, right ventricular hypertrophy

    Pulmonary
    • Pneumonia, pleuritis, bronchitis, pneumothorax, tumor
    Gastrointestinal
    • Esophageal rupture, gastroesophageal reflux disease (GERD), esophageal spasm, Mallory-Weiss syndrome, peptic ulcer disease, biliary disease, pancreatitis, functional gastrointestinal pain

    Musculoskeletal
    • Cervical or thoracic disk disease or arthritis, shoulder arthritis, costochondritis (anterior chest wall syndrome or Tietze’s syndrome), subacromial bursitis

    Other
    • Anxiety or panic attack, herpes zoster, breast disorders, chest wall tumors, thoracic outlet syndrome, mediastinitis
    Dispnéia
    Acute
    • Asthma, pneumonia, pulmonary edema, pneumothorax, pulmonary embolus, metabolic acidosis, acute respiratory distress syndrome, panic attack

    Pulmonary
    • Airflow obstruction (asthma, chronic obstructive pulmonary disease, upper airway obstruction), restrictive lung disease (interstitial lung disease, pleural thickening or effusion, respiratory muscle weakness, obesity), pneumonia, pneumothorax, pulmonary embolism, aspiration, acute respiratory distress syndrome

    Cardiac
    • Myocardial ischemia, congestive heart failure, valvular obstruction, arrhythmia, cardiac tamponade

    Metabolic
    • Acidosis, hypercapnia, sepsis

    Hematologic
    • Anemia, methemoglobinemia

    Psychiatric
    • Anxiety