Patients with disease of the respiratory system generally present because of symptoms, an abnormality on a chest radiograph, or both. A set of diagnostic possibilities often is suggested by initial problems at presentation, including the particular symptoms and the appearance of any radiographic abnormalities. The differential diagnosis is then refined on the basis of additional information gleaned from physical examination, pulmonary function testing, additional imaging studies. This study will consider the approach to the patient based on the major patterns of presentation, focusing on the history, the physical examination, and others. Information about risk factors for lung disease should be explicitly explored to assure a complet basis of historical data. The physical examination should be directed not only toward ascertaining abnormalities of the lungs and thorax, but also toward recognizing other findings that may reflect underlying lung disease.
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