Acute Dyspnoea and Haemoptysis Flashcards
Differentials for acute dyspnoea and haemoptysis. (General categories)
- Pulmonary causes
- Cardiac
- Non-cardiorespi
What are the airway diseases (under pulmonary causes) that can cause acute dyspnoea and haemoptysis?
- Chronic bronchitis and emphysema
- Asthma
- Bronchiectasis
- Pharyngeal or laryngeal tumour
- Cystic fibrosis
Patient presents with acute dyspnoea and haemoptysis, what pulmonary causes are there? (General categories)
- Airway disease
- Parenchymal
- Vascular (pulmonary circulation)
- Chest wall and pleura
Patient presents with acute dyspnoea and haemoptysis.
What lung parenchymal diseases can cause it?
- Pneumonia
- Pulmonary fibrosis
- Sarcoidosis
- Diffuse infections
- Infiltrative or metastatic tumours
- Bronchiolitis / alveolitis
- ARDS
Patient presents with acute dyspnoea and haemoptysis. What can go wrong with the pulmonary circulation that causes these symptoms?
- PE
- Pulmonary AV malformaiton
- Pulmonary arteritis
Patient presents with acute dyspnoea and haemoptysis. Is there anything that can go wrong with the chest wall and pleural areas that can cause these symptoms?
- Pleural effusion
- Tension pneumothorax?
- Invasive pleural tumour
What are the cardiac causes of dyspnoea?
- LVF
- MS/MR > pulmonary oedema
- Intracardiac shunt (relative hypoxemia)
- Cardiomyopathy
- Pericardial effusion, pericarditis
What are the non-cardiorespi causes of dyspnoea?
- Psychogenic dyspnoea
- Anaemia
- Respiratory acidosis
- Hypothalamic lesions
What is the coagulation pathway starting from Factor V and ending in thrombin?
Factor V > Factor X > thrombin (pro-thrombin)
Read as: factor 5 activates factor 10, which in turn activates thrombin from pro-thrombin
Which are pro-thrombotic, which are anti-thrombotic molecules? Factor V, Factor X, Protein C, thrombin, pro-thrombin.
Pro-thrombotic: Factor V and X, thrombin and pro-thrombin
Anti-thrombotic: Protein C (inactivates Factor V)
How is Factor V leiden different from normal Factor V?
It is resistant to inactivation by Protein C (which is an anticoagulant) causing tendency to clot.
What is Virchow’s triad? (3)
- Endothelial injury
- Stasis
- Derangements of blood constituents
Most PEs arise from which veins?
Popliteal veins and larger veins above it
What are risk factors for thrombosis (hypercoagulability)?
- Surgery, immobility
- Trauma (burns, fractures)
- Women’s: COCP, HRT, pregnancy
- Lifestyle: smoking, obesity
- Long haul flight
- Medical: CCF, HTN, antiphospholipid syndrome, cancer, COPD
