The Clinical Problem Solvers Episode 425: Schema Episode – Ground Glass Opacities
Oct 15, 2025
A captivating case of dyspnea with ground-glass opacities unfolds as the hosts tackle diagnostic challenges. They explore the anatomy behind hypoxia and discuss community-acquired pneumonia's diagnostic criteria. Delving into the patient's history reveals bird exposure and potential mold triggers. Discussion shifts to balancing antibiotic use and viral testing amidst exclusion of infections. As the plot thickens, findings lead to a diagnosis of hypersensitivity pneumonitis, with an emphasis on management through exposure removal and ongoing follow-up.
AI Snips
Chapters
Transcript
Episode notes
Practical Bedside Approach To Hypoxia
- Inspect the upper airway and trachea first when evaluating hypoxia at the bedside.
- Use auscultation/ultrasound and chest x-ray to localize alveolar/pleural filling versus vascular causes like PE.
CAP Is A Clinical Diagnosis
- Community-acquired pneumonia (CAP) is a clinical diagnosis, not purely radiographic.
- Chest x-ray misses ~30% of pneumonias, while CT is more sensitive and often necessary when suspicion remains high.
Ground-Glass Opacities Are Broad But Localizable
- Ground-glass opacities (GGOs) represent partial alveolar filling and are nonspecific.
- Use distribution (centrilobular, perilymphatic, random) and clinical context to narrow the differential.
