Respiratory- Common PC Haemoptysis

Question 1

Haemoptysis what is it

Answer 1

• haemoptysis means coughing up blood from the respiratory tract
• what it can complicate any severe forceful cough, never assume haemoptysis has a benign cause, particularly in a smoker until underlying cause has been excluded

Question 2

Haemoptysis- features to enquire about

Answer 2

• was it coughed up from the chest- check vomit, epistaxis, mouth, gums
• when did blood appear and how much
• any associated Sx and over what time period
• any fevers or Sx of infection- particularly cautious of TB
• recurrent blood streaks in sputum should prompt Ix for lung cancer
• blood streaks for years suggests bronchiectasis
• a sudden episode of haemoptysis with pleuritic pain and breathlessness suggests PE
• large volumes of haemoptysis suggest: lung cancer, bronchiectasis, TB, pulmonary vasculitis, pulmonary arteriovenous malformation

Question 3

Stridor

Answer 3

• harsh, grating sound caused by vibration of the tracheal walls when the airway lumen is critically narrowed by compression, tumour or foreign objects
• inspiration lowers the pressure inside the extra thoracic trachea, so critical narrowing here leads to inspiratory stridor
• in contrast intrathoracic large airways are compressed during expiration by positive pressure surrounding the lung
• large airway compression may lead to inspiratory and expiratory stridor
• rapid Ix and Tx are vital