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Critical Diagnostic Thinking in Respiratory Care: A Case-based Approach

James K. Stoller MD, MS, Head, Section of Respiratory Therapy, Professor and Vice Chairman of Medicine, Department of Pulmonary/Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, OH
ISBN 072168548X · Paperback · 326 Pages · 46 Illustrations
Saunders · Published 2002
This book is organized into four logical sections. Section 1 is a thorough introduction to the processes involved in developing critical diagnostic thinking. It demonstrates how to use information from the patient's history and physical examination to develop the differential diagnosis: an ordered list of likeliest causes.

The other sections of the book present cases typical of three broad clinical settings: outpatient, inpatient non-ICU, and ICU. Each of the chapters in these sections begins with a clinical vignette posing an important respiratory problem with an accompanying description of the history and physical examination. This is followed by a review of the common and uncommon causes of the patient's symptom(s). The likelihood of a specific cause of the symptom is then analyzed using the specific features of the patient's history and physical examination. Finally, each chapter closes with a section on some of the more common pitfalls in diagnosing the patient.

Contents
Section I: Background
An Introduction to Critical Diagnostic Thinking
Section II: Common Presentations in the Outpatient Setting
Chronic Cough
Recurrent Episodes of Purulent Phlegm
Progressive External Dyspnea
Progressive External Dyspnea in a 65 Year Old Man {tentative}
Fatigue Associated With Daytime Sleepiness
Solitary Pulmonary Nodule
Hemoptysis
Digital Clubbing
Bilateral Pleural Effusions
Unilateral Right-Sided Pleural Effusions
Platypnea
Chronic Hypercapnea
Community Acquired Pneumonia
Pleuritic Chest Pain
Non-Pleuritic Chest Pain
Upper Lobe Infiltrate
Wheezing
Stridor
Cavitary Pulmonary Infiltrate
Bilateral Hilar Adenopathy
Section III: Common Problems in the Non-ICU Adult Inpatient
Fever and a Pulmonary Infiltrate
Hypoxia
Hypercapnic Respiratory Failure
Atlectasis
Preoperative Evaluation
The Difficult-to-Wean Patient
The Weak Patient
Ventilatory Dys-synchrony
Hypotension with Mechanical Ventilation
Immediate Reintubation
Subcutaneous Emphysema
Bubbling Chest Tube
Refractory Hypoxemia
High Peak Airway Pressures
Ventilator-Associated Pneumonia