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RESPIRATORY
Differential diagnosis of common respiratory conditions (Guidelines)

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Differential diagnosis of common respiratory conditions (Guidelines)

TAM (Treatments and Medicines) NHS Highland

Diagnosis	Suggestive features
COPD (Chronic Obstructive Pulmonary Disease)	Onset in mid-life Symptoms slowly progressive History of tobacco smoking or exposure to other types of smoke Physical activity Flu vaccination Pneumococcal vaccination
Asthma	Onset early in life (often childhood) Symptoms vary widely from day to day Symptoms worse at night/early morning Allergy, rhinitis, and/or eczema also present Family history of asthma Obesity coexistence
Congestive heart failure	Chest X-ray shows dilated heart, pulmonary oedema. Pulmonary function tests indicate volume restriction, not airflow/imitation
Bronchiectasis	Large volumes of purulent sputum Commonly associated with bacterial infection Chest X-ray/CT shows bronchial dilation, bronchial wall thickening.
Tuberculosis	Onset all ages Chest X-ray shows lung infiltrate Microbiological confirmation High local prevalence of tuberculosis
Obliterative bronchiolitis	Onset at younger age, non-smokers May have history of rheumatoid arthritis or acute fume exposure Seen after lung or bone marrow transplantation CT on expiration shows hypodense areas
Diffuse panbronchiolitis	Predominantly seen in patients of Asian descent Most patients are male and non-smokers Almost all chronic sinusitis Chest/X-ray and high-resolution computed tomography show diffuse small centrilobular nodular opacities and hyperinflation
These features tend to be characteristic of the respective diseases, but are not mandatory. For example, a person who has never smoked may develop COPD (especially in the developing world where other risk factors may be more important than cigarette smoking); asthma may develop in adult and even in elderly patients.

Last reviewed: 03/12/2021

Next review date: 03/12/2024

Author(s): Respiratory Department .

Version: 1

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Michelle Duffy, Advanced Practice Respiratory Nurse.

Document Id: TAM364