3. Prepared by Dr.Maihan (yousufi)
Instructor: professor Dr.Hayatullah
Ahmadzai
Total slides: 33
6/2/2017
University hospital,nangarhar,Afghanistan
Maihan_yousufi@yahoo.com
4. Reference:
Respiratory and heart valves
Reheumatismal diseases of
professor Dr.Moh. Tayab Neshat
Harrison 19edition
Davidson 22 edition
Current medical diagnosis 2017
Washington manual 35edition
5. Definition of hemoptysis
Classification of hemoptysis
Epidemiology of hemoptysis
Causes of hemoptysis
Diagnosis of hemoptysis
Main objectives:
6. …continuous Main objectives:
Definition of cough
Types of cough
Origin and Causes of cough
Investigation
Treatment
17. Diagnosis
1.History taking:
amount of
hemoptysis
Age
smoking history
prior lung disease
Renal disease(good pasture s)
risk for coagulopathy (anti
coagulant)
prior episodes of hemoptysis
malignancy
18. …continuous Diagnosis
III. Physical examination:
general state of health
Vital signs
oxygen saturation
Lung exam noting focal or diffuse
abnormal findings such as bronchial
breath sounds, crackles ,
inspiratory or expiratory wheezes
19. Diagnostic testing
I. Lab and ECG:
ECG to assess for underlying
structural heart disease
CBC, coagulation studies
Blood grouping and cross match
if massive hemoptysis is present
20. …continuous Diagnostic
testing
Sputum studies: Gram stain and
culture for AFB,fungal infections.
Immunologic studies: Anti nuclear
ab/Ant neutrophil cytoplasmic ab
screen,anti glomerular basement
membrane antibodies.
BNP: CHF
21. …continuous Diagnostic
testing
II. Imaging:
CXR: PA and lateral CXR should
be perform for all causes of
hemoptysis.(1.normal up to 50%
of causes. 2. normal up to 10%
of causes by bronchogenic
carcinoma.)
26. Definition:
Cough is an explosive expiration
that provides a normal protective
mechanism for clearing of
tracheobronchial tree of secretion
and foreign body.
27. Types of cough
I. Acute cough (less than 3weeks)
Exp: viral respiratory tract infection
II. Persistent cough(3-8 weeks)
Exp: pertussis
III. Chronic cough(more than 8 weeks).
Exp: post nasal
drip,GERD,asthma,bronchogenic
carcinoma,pul.TB, ACE inhibitors.
28. Origin and Causes of cough:
origin Common causes Clinical features
Pharynx Post nasal drip History of Ch. Rhinitis
Larynx 1.Laryngitis,tumour,
2.whooping cough, croup
1.Voice or swallowing altered, harsh or painful
cough
2.Paroxysmal cough with stridor
Trachea Tracheitis Raw retro sternal pain with cough
Bronchi 1.A.bronchitis,COPD,
2.asthma
3.Eosinophilic bronchitis
4.Bronchial carcinoma
1.Dry or productive cough, worse in morning
2.Usually dry, worse at night
3.Feature similar to asthma but Air way hyper
reactivity absent, sputum eosinophilia is
present.
4.Chronic cough often with hemoptysis.
29. …continuous Origin and
Causes of cough:
origin Common causes Clinical features
Lung parenchyma 1.Pulmonary TB
2.Pneumonia
3.Bronchiectasis
4.Pulmonary oedema
5.Interstitial fibrosis
1.Productive often with hemoptysis
2.Dry initially, productive later
3.Productive, excessive sputum
production mal odors.
4.Often at night may be productive
pink frothy sputum.
5.Dry and distressing
Gastro intestinal
disorders
GERD History of gastro intestinal disorders
(regurgitation, heart burn),Dry cough
