By E.E Payne
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Extra resources for An Atlas of Pathology of the Brain
It is important to look for associated systemic features. In the late stages of the disease, signs of pulmonary hypertension or cor pulmonale may be present. Diagnosis 28 Clinical assessment A proper history is very important. It should include the mode of onset, associated systemic features, presence of other disease conditions, smoking Laboratory tests These include full blood count including eosinophil count, urea and electrolytes, liver function tests, serum immunoglobulins, ESR, rheumatoid factor, ANCA and serum precipitins.
The chest movement is diminished and the percussion note is hyper-resonant. In SSP, the clinical signs may not be prominent due to underlying lung disease. The pneumothorax is visible when the air in the pleural space rises to the apex. The margin of visceral pleura is seen separate from the chest wall with an area of hyperlucency and loss of vascular markings. Sometimes artefacts like skin folds or clothing may appear as lung margin. If in doubt, the CXR should be repeated or a CXR with breath held in expiration may be helpful.
CT gives more detailed information and may reveal small leakage of air in the mediastinum but it may fail to show the site of leakage. Contrast study with a non-ionic water-soluble contrast agent usually reveals the site of rupture. Treatment Keep nil by mouth, with circulatory support, broad-spectrum antibiotics and urgent surgical repair. This usually occurs at the workplace as seen in workers involved in mining and 25 Section 1: Chest manufacturing, construction, shipbuilding, pipe ﬁtters and boilermakers.
An Atlas of Pathology of the Brain by E.E Payne