1. INVESTIGATIONS

2. RESPIRATORY CAUSE
• 1- Examination of sputum
• 2- Radiology of chest
• 3-Bronchoscopy
• 4-Broncho alveolar lavage
• 5- Lung biopsy
• 5- pulmonary function tests

3. NON RESPIRATORY CAUSE
CVS
X-Ray CT MRI ECG
GERD
 Barium meal

4. EXAMINATION OF SPUTUM
 Inspection
 Microscopy
 microbiological Examination

5. 1-INSPECTION
Colour
Smell
Quantity

6. • Viscid & yellow
* a/c bronchitis
* Bronchiectasis
* Lung abscess

7. • White & Mucoid
* c/c bronchitis
* Bronchial Asthma
* Pulmonary Tuberculosis

8. • Rusty sputum
* pneumonia

9. • Cursch-man’s spirals
Bronchial asthma
Allergic bronchopulmonary aspergillosis

10. • Watery & blood stained sputum
* Pulmonary edema

11. • Blood in sputum [hemoptysis]
*TB, *Pneumonia,
*Bronchiectasis, * Lung abscess,
*Mitral Stenosis, *Bronchogenic carcinoma

12. • Chocolate coloured sputum
* Amoebiasis

13. Foul smell
• c/c suppuration
bronchiectasis lung abscess

14. 2-MICROSCOPY
• Wet preparations
entamoeba, paragonimus
• Wet staining wt methylene blue
malignant cells
• Gram’s staining
bacterial pathogens

15. • Ziehl – Neelsen Staining
* mycobacteria
 50,000/ml- sputum positive
*at least 2 bacilli
*at least 100 fields

16. • Papanicolaou stain
* cytological abnormalities
* identify malignant cells
* demonstrate bronchial casts

17. 3-MICROBIOLOGY
Culture of sputum
Drug sensitivity

18. RADIOLOGY OF CHEST
• PA view chest investigation of choice
• Lateral viewlobar/segmental pathology
• Anterior oblique view abnormality of heart
[atrial & ventricular enlargement]

21. TB- pulmonary nodule

22. Advanced b/l TUBERCULOSIS

23. PULMONARY MASS

24. LUNG CANCER

25. LUNG ABSCESS

26. Rt basal consolidation & pleural
effusion

27. Rt upper lobe consolidation

28. Rt lower lobe consolidation

29. TOTAL LUNG COLLAPSE

30. MEDIASTINAL SHIFT IN PULMONARY
COLLAPSE

31. PULMONARY FIBROSIS

32. Lung cavitation

33. CYST

34. Coin lesion

35. Cannon balls

36. Emphysema

38. PNEUMOTHORAX

39. Hydropneumothorax on left side

40. PLEURAL EFFUSION

41. CT SCAN

42. Bronchogram
• Delineate bronchial tree
bronchiectasis
intrabronchial obstruction

45. BRONCHOSCOPY

46. CARDIOMEGALY

47. ECG

48. GERD

49. GERD BARIUM MEAL