Hemoptysis Flashcards
Where can the blood with coughing be originating from?
the supralaryngeal airways
the larynx
the upper gastrointesinal tract
the lower respiratory tract
What is hemotypsis?
Hemoptysis refers specifically to the expectoration of blood from a source within the lower respiratory tract (distal to the larynx)
T or F: hemotypsis requires prompt assessment
T
What determines the urgency of assessment of hemotypsis?
The urgency of the assessment is determined largely by the rate of bleeding
Whats the approach to hemoptysis?
ABCs--> History --> Physical exam --> CXR/Lab Evaluations --> Special procedures (bronchoscopy)--> Therapeutic interventions --> Evaluation of response
T or F: hemoptysis can cause asphyxiation
T
How to stabilize the patient?
Supplemental oxygen Cough suppression (codeine) Suctioning of secretions Intubation and ventilation if necessary --> helps restore gas exchange, facilitates airway suctioning, and prevents contamination of normal lung areas with blood
Can anemia occur with hemoptysis?
Yes, Anemia can occur with ongoing, subacute or chronic hemoptysis
Why does cardiac failure occur in patients with hemoptysis?
Circulatory collapse is usually the result of the acute, asphyxia-induced respiratory failure (hypoxemia and hypercapnia with acidosis)
What dictates if hemoptysis is life-threatening?
The rate of bleeding into the airway
The patient’s ability to expectorate the blood
The underlying cardiopulmonary status of the patient
What are some infectious causes of hemoptysis?
Bronchitis Bronchiectasis Cystic fibrosis Bacterial pneumonia M. tuberculosis Fungus (mycetoma) Lung abscess Pulmonary gangrene Septic emboli
What is a neoplastic cause of hemoptysis?
Primary: bronchogenic carcinoma, carcinoid
What are some vascular causes of hemoptysis?
Pulmonary thromboembolism
Primary and secondary pulmonary hypertension
Cardiac failure
What are some immunological causes of hemotypsis?
Goodpasture’s, Wegener’s, systemic lupus erythematosus
T or F: iatrogenic and hematologic causes can cause hemotypsis?
T
What percentage of hemoptysis is caused by idiopathic reasons?
10-20%
What is the most common cause of hemoptysis?
bronchitis (either acute or chronic) is the most common cause of hemoptysis (usually bloody streaking of sputum; rarely more life-threatening hemoptysis)
in smokers lung cancer must be ruled out
Which vasculature is more often implicated in hemotypsis?
Most often the communication is at the level of the more central, large airways supplied by the high pressure systemic circulation
If hemoptysis is seen as localised infiltrates, what does it mean?
Pneumonia/infection
Pulmonary infarct (pleural based)
Aspirated blood
If hemoptysis is seen as diffuse and bilateral infiltrates, what does it mean?
Diffuse alveolar hemorrhage
Congestive heart failure
Toxic gas inhalation
If hemoptysis is accompanied with mass lesion or lymphadenopathy on chest imaging what does it mean?
neoplasm
T or F: in a chest imaging of a hemoptysis patient with multlple lesions mean they have asthma
F
means they may have:
Septic emboli
Wegener’s granulomatosis
What do cavities on chest imaging mean?
Tuberculosis (apico-posterior segments of upper lobes or superior segements of lower lobes)
Squamous cell carcinoma
Cavitating pulmonary infarct
What do cavity with “air-crescent” mean on chest imaging?
mycetoma
