58021

Figurę 3.9

Drffcrcncial diagnosis of COPD

COPD	Onset in mid-lifc Symptoms slowty progressivc Commonly long smoking history Rarely «t-an tury psin deficiency Rarcly primary ciliary dyskincsia	Oyspnoa duńng cxcrctse Largcły irrcvcrsibłc airflow limrtauon
Asthma	Onsct carły in lifc (often childhood) Symptoms vary from day to day Symptoms at night/carly morning	Allergy. rhimns. or cczcma also prcscnt Family history of asthma Rcspoods to pj-agonists: rcvcrsiblc airflow limitation
Congcstwc hcart failure	Finc basilar cracklos on auscultatton Chcst X-ray shows dllatcd hcart. pulmonary cdcma	Pulmonary function tcsts includc volumo rcduction. not airflow limitation - no obstructive pattem
Broochiectasis	Bronchial drfation and suppuraoon Largc volumes of purutent sputum Commonły assooated with bacteoal infection	Coarsc cracklos on auscultation Chest X-ray/CT shows bronchial dilaoon. bronchial wali thickoning
Tuberculosis	Onset at all agcs Chest X-ray shows lung infiltratc or nodular lesions	Microbiologłcal confirmation High local prcvałence of tubcrcuk>sts
Ob!aer3trve bronchśolitis	Onsct in youngcr agc. non-smokcrs May havc history of rheumatoid arthritts or fume cxposure	CT on cxpiration shows hypodense areas
Dtffuse panbronchiokrt	Most paticnts are małe and non-smokers Chcst X-ray and high-rcsołut*on CT show Almost all havc chroń* smusitis diffusc smali ccntrilobuiar nodular opacities and hypennflation