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Investigations in Respiratory Diseases

General investigations of importance which indicate disease from the respiratory organs include peripheral blood picture, total and differential leukocyte counts and resolution of ESR. Lymphocytosis is suggestive of chronic inflammatory disease like tuberculosis whereas neutrophil leukocytosis is situated acute infections like pneumonia. Surge in eosinophils above 10% necessitates estimation from the absolute eosinophil count. Mild and moderate rise in eosinophils is incredibly common in Indian subjects. This can be caused by factors like helminthiasis and external allergens. In susceptible subjects even moderate eosinophils may present with the signs of respiratory allergy. High eosinophil counts are found in allergies, hydatid disease and pulmonary eosinophilia. Chronic hypoxemia ends in the creation of secondary polycythemia. Elevation of ESR is a nonspecific indicator of inflammatory and neoplastic lesions inside the lungs. Erythrocyte sedimentation minute rates are not only a reliable parameter for diagnosis, however in the follow-up of an chronic disease like tuberculosis, the ESR might be helpful.

Sputum examination Sputum needs to be examined macroscopically, microscopically after proper staining, and bacteriologically. Total quantity of sputum in A day, color, consistency and other characteristics like odor and presence of blood are of great value in diagnosis. Presence of fungi in mycotic infections, asbestos bodies in asbestosis and ANC Calculator motile amoebae in pulmonary amoebiasis might be detected by direct microscopy of fresh sputum. Gram's stain and Ziehl-Neelsen's stain widely-used to identify the bacterial pathogens in the smear. Malignant cells can be detected by cytological examination, Wet preparations stained with methylene blue might point to a good malignant cells, some staining assist to identify the malignant cells further.

Bacteriological tests Sputum culture is conducted to distinguish the organisms in addition to their sensitivity to numerous antibiotics. Proper collection of the specimen is important getting reliable results. Sputum must be taken into sterile receptacles. Contamination by oropharyngeal organisms results in fallacious results on culture. Uncontaminated specimens of sputum can be obtained by trans-tracheal aspiration. Bronchial washings collected via a bronchoscope or smears collected by a brush during bronchoscopy are ideal specimens for cytological and microbiological studies, wherever facilities are available.

Radiological studies Plain X-ray chest-posteroanterior (PA) view Radiographs are taken in full inspiration with all the film used in front with the chest along with the method to obtain X-rays kept 1.5-2m behind the sufferer. Together with PA views, lateral views are also taken while using affected side near the film to locate the bronchopulmonary segment the seat of disease. In normal skiagrams, the lungs appear as translucent zones by which bronchovascular markings are clearly detectable and may be traced almost on the periphery.

The trachea, mediastinum, costophrenic, and cardiophrenic angles along with the a higher level the diaphragm are taken as landmarks within the interpretation of chest skiagram. On either sides the lung fields are compared zone by zone. For purpose of description the lung fields are divided into the top of, middle, along with the lower zones. A horizontal line on the a higher level the lower margin of the anterior end in the second rib separates the top from middle zone, plus a horizontal line passing over the lower margin from the anterior end with the fourth rib separates the very center through the lower zone. Chest radiographs give proof of morphological lesions. In most cases, radiological appearances assist to infer the aetiology too.

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