Hemoptysis case presentation

57 %
43 %
Information about Hemoptysis case presentation
Health & Medicine

Published on September 12, 2014

Author: Alsheef

Source: slideshare.net

Description

Hemoptysis
case scenario
DDx
How to diagnose
Guidlines and protocols

Hemoptysis DMC Hussain Alsheef ENT resident

Case scenario  25 y/o Saudi male, smoker , medically free  c/o coughing blood for 3days  No SOB or chest pain  No hoarsness , dysphagia , odynophagia or chocking  No nasal obstruction or epistaxis  No bleeding disorder  No contact with TB pt.  No fever or wt. loss

O/E  Laying comfortably on bed not on distress  Not pale  V/S : BP=124/80 , P=84 , O2 sat=99% on room air , T=36.7  Throat : no post nasal bleeding  Nose :  Ant. Rhinoscopy : free  Flexible scope : no bleeding points seen in nasal septum or turbinates  Pharynx and larynx free  Neck : no lymph nodes

Investigations  Blood inv.  CBC  Chemistry  Coagulation profile  Imaging studies  CXR  CT scan  Scope

DDx

Airway diseases Inflammatory (bronchitis , bronchiectasis) F.B Airway trauma Neoplasms (bronchogenic ca.) Lungs Infections Tb. , pneumonia Autoimmune diseases (wegner ,goodpasture syndrome , SLE Pul.vasculature Lt. heart failure Pulmonary AV malformation Thrombo-embolism Others Coagulopathy Cocaine use Iatrogenic

Hemoptysis  expectoration of blood  typically from the lower respiratory tract,  upper (respiratory & GI) tracts can be expectorated and mimic blood coming from the lower respiratory tract  Hemoptysis is classified as nonmassive or massive based on the volume of blood loss  Massive hemoptysis > 200cc / day  The low-pressure pulmonary system tends to produce small-volume hemoptysis, whereas bleeding from the bronchial system, which is at systemic pressure, tends to be profuse  most common causes of hemoptysis are acute and chronic bronchitis, pneumonia, tuberculosis, and lung cancer Infection : 60-70% of cases Cancer : 23% of cases in US

Evalutation of hemoptysis CBC , coagulation , RFT CXR Flexible bronchoscopy CT

Key points  Hemoptysis needs to be distinguished from hematemesis and nasopharyngeal or oropharyngeal bleeding.  Bronchitis, bronchiectasis, TB, and necrotizing pneumonia or lung abscess are the most common causes in adults.  Lower respiratory tract infection and foreign body aspiration are the most common causes in children.  Patients with massive hemoptysis require treatment and stabilization before testing.  Bronchial artery embolization is the preferred treatment for massive hemoptysis.

References  Uptodate.com Etiology and evaluation of hemoptysis in adults  Merck Manual Hemoptysis .. Last reviewed literature on July 2014

Thank you

Add a comment

Related presentations

Related pages

Hemoptysis_case presentation and discussion - scribd.com

An Interactive: Case Presentation Hemoptysis Night Float team Danish Ejaz Bhatti Khouroush Hudsony Lalit Kalra Brain Storming Differential Diagnosis
Read more

Case 12-2006 — A 37-Year-Old Man with Hemoptysis and a ...

Presentation of Case. Dr. Michael D. Howell (Pulmonary and Critical Care Unit): A 37-year-old man was seen in the pulmonary clinic of this hospital because ...
Read more

Hemoptysis: Diagnosis and Management - American Family ...

Hemoptysis is the spitting of blood that ... usual practice, expert opinion, or case ... The most common presentation is acute, mild hemoptysis caused ...
Read more

Apathetic Thyrotoxicosis Presenting with Hemoptysis

Sheyin, Olusegun, Taiwo Falade, and Olufemi Fasanmade. "Apathetic Thyrotoxicosis Presenting with Hemoptysis." American Journal of Medical Case Reports 2.9 ...
Read more

A Case of Hemoptysis - Emory Department of Pediatrics

Title: A Case of Hemoptysis Author: Vineet Kumar Gupta Last modified by: Robert Migliore Created Date: 4/7/2002 10:07:51 PM Document presentation format
Read more

Management of Hemoptysis in the Emergency Department

empirically to define hemoptysis in reported case stud- ... Management of Hemoptysis in the Emergency Department Eddy Jean-Baptiste, MD, PhD.
Read more

A 75-Year-Old Female with Hemoptysis and Recurrent ...

This paper describes the case of a 75-year-old female who presented with significant hemoptysis over a 7–10 day period. She had a history of a left ...
Read more

Case 14-2002 — A 51-Year-Old Woman with Recurrent ...

Presentation of Case A 51-year-old woman was admitted to the hospital because of recurrent hemoptysis. The patient had been well until 18 months earlier ...
Read more