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HEMOPTYSIS

jillian
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HEMOPTYSIS

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    2. HEMOPTYSIS

    3.

    4. Severity

    5. Etiology Make sure it is Hemoptysis DDx: Hematemesis Epistaxis Other nasopharyngeal bleeding

    6. Etiology Infectious Malignancy Trauma/ FB Cardiac/pulmonary vascular DAD Factitious Cryptogenic

    7. Etiology: Classification by site

    8. Incidence & Frequency Varies in different study populations May reflect incidence of certain disease in that certain population

    9. Etiology

    10. Etiology

    11. Approach to Patient with Hemoptysis History & Physical Examination: Assess Severity & Urgency Duration of bleeding Extent of bleeding Reliability Assess the Cardio-Respiratory reserve Prior Episodes of bleeding Clues to the cause

    12. Clues from the Hx

    13. Clues from the Hx

    14. Clues from the Hx History of previous or co-existing disease

    15. Clues from the P/E H&N Chest Heart Abdomen Skin CNS

    17. Diagnostics After comprehensive Hx & P/E Goals: Identify the cause Localize the site of bleeding Assess the general condition of the patient

    18. DDx of Hemoptysis + Hematuria GBS WG SLE CA Lung ( Membranous GN) Renal cell CA ( Lung Mets) Bleeding diathesis

    19. Radiologic studies CXR Normal in up to 30 % Abnormality may not reflect the exact site of bleeding Why? CT Scan : higher yield HRCT in certain Dx ( Bronchiactasis) ?82-97% ( compared with 37% in CXR)

    20. Chest radiograph and computed tomography (CT) in a patient who has a cavitary, squamous cell carcinoma. The cavitary lesion cannot be seen on the chest radiograph, But it is clearly demonstrated by the CT scan .

    22. Bronchoscopy

    23. Bronchogenic carcinoma visualized through the fiberoptic bronchoscope. The tumor occludes the left upper lobe and is actively bleeding

    24. Other Radiologic studies

    25. Management Varies with the severity of bleeding The cause of bleeding General condition /Cardio-resp. Reserve

    26. Management of Non-Massive Hemoptysis

    27. Management of Massive Hemoptysis

    28. Management of Massive Hemoptysis

    29. Interventions Iced Saline Lavage Topical vasopressors Selective intubation / ventilation Endobronchial tamponade Laser photocoagulation Bronchial artery embolization Surgery ( Lobectomy / Pneumonectomy)

    31. What was the cause of Marys hemoptysis ?

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