Hemoptysis

Question 1

amount of massive hemoptysis?

Answer 1

500 cc in 24 hours, rate of 100/hr

Question 2

blood supply for pleura and bronchi?

Answer 2

bronchial arteries

Question 3

BS for lung parenchyma?

Answer 3

pulmonary vessels

Question 4

causes of massive hemoptysis?

Answer 4

neoplasm(bronchogenic carcinoma), mycetoma- upper lobe cavitary disease, DAH, AVM, PHTN, CHF, catamenial endometriosis, drugs(bevacizumab, amio, PTU, sirolimus)

Question 5

positioning for treating massive hemoptysis?

Answer 5

bleeding lung down, double lumen ETT

Question 6

bronch interventions for hemoptysis?

Answer 6

tamponade device, iced saline, epi

Question 7

bronchial artery embolization complications?

Answer 7

rebleeding( can reattempt), spinal artery embolization

Question 8

when to do surgery for hemoptysis?

Answer 8

localized and unilatera, failed other therapies, malignancy

Question 9

tx for bleeding aspergilloma?

Answer 9

embo is temporary, lobectomy is definitive

Question 10

Rasmussens aneurysm

Answer 10

bleeding for the PA that is adjacent to a tuberculous lesion

Question 11

when would you use plasmapharesis for pulmonary hemorrhage?

Answer 11

goodpasture syndrome, with circulating ab

Question 12

tx for DAH?

Answer 12

steroids, then rituxan

Question 13

drugs that can cause hemoptysis

Answer 13

bevacizumab, amiodarone, blood thinners, antiplatelet, siroliumus

Question 14

mycetoma

Answer 14

prior fungal infection can cause hemoptysis

Question 15

first. diagnostic test for hemoptysis?

Answer 15

bronchoscopy

then CTA