Airway obstruction

Question 1

Etiology

Answer 1

1. Intraluminal
Foreign body
Blood clot
Vomitus
Sputum
2. Wall 
Epiglotittis
Laryngeal edema
Neoplasm
Strictures, granulation, malacia, stenosis
Anaphylaxis
3. Outside
Trauma
Thyroid mass
Neck hematoma

Question 2

Malignant causes of CAO

Answer 2

1. Extension of adjacent tumor w/ airway invasion->esophageal, laryngeal, thyroid
2. Primary intraluminal malignancy->SCC and adenoid cystic carcinoma
3. Endobronchial disease
4. Compression from a contiguous malignant process

Question 3

Symptoms

Answer 3

1. Shortness of breath
2. Cough
3. Hemoptysis
4. Wheeze
5. Stridor

In a ventilated patient:
1. +airway pressures, -ve tidal volumes, hypoxemia and hypercapnia

Question 4

Risk factors

Answer 4

1. Lung cancer
2. Primary airway malignancy
3. Smoking
4. Artifical airways
5. Tracheobronchial stents
6. TE oxygen catheters
7. Lung transplant
8. NeurocogN/NeuroM disorders
9. Granulomatosis w/ polyangitis

Question 5

Investigations

Answer 5

1. CXR
   Tracheal deviation, mediastinal shift, post-op pneumonia, atelectasis, collapse
   ? Consider
2. Bronchoscopy
3. CT scan: look for narrowing, masses, SOL, filling defects
4. MRI: vascular rings, aneurysms, soft tissue masses
5. Spirometry

Question 6

Differential

Answer 6

1. COPD

2. Asthma

Question 7

History

Answer 7

1. Active/past malignancy
2. Critical deseases requiring mechanical ventilation
3. Previous surgical interventions
4. Rheumatological conditions
5. Infections: TB, histoplasmosis
6. Comorbidities: smoking, diabetes, HTN, high ASA
7. Assess aspiration risk

Question 8

Management

Answer 8

1. ABC
Establish secure airway
2. High flow oxygen
3. Consider heliox
4. Bronchodilators