1.Haemoptysis

2. Case 1
23 y /M/known to have pulmonaryTB diagnosed6 years ago ,pt received full with anti TB ,ONE year ago pt developedproductive cough with SOB sick medical advice outside Sudan endedwith segmenectomy of the lower part of the Lt upper lobe.
C/o high grade fever
Cough
Hemoptysis(small amount)
3. This pt is not breathless at rest ,The fingers are not clubbed ,there is no evidence of nicotine staining,The venous pressure is not elevated, There are no palpable LN, The trachea is slightly deviated to the Lt .On inspection of the chest ,there is Lt thoractomy scare with flattening of the Lt chest wall .The apex beat is displaced to the Lt.Chest expansionis reduced on the Lt.There are coarse inspiratory crepitationbilaterally with widespreadexpiratory wheeze.
4. Diagnosis post TB Broncheictasis
5. Case 2
70 years/M/ x.smoker(30 cigarette/day for 20 year lifted 15years ago)
C/O hemoptysis (sudden twice moderate in amount)
Thisa gentleman not breathless at rest
Examination was normal
CXR Rt lower zone MASS
DiagnosisCarcinoma of thelung
6.
Case 3
21y/M

C/O Cough
Massive hemoptysis
This pt not breathless at rest emaciated very pale with a collection of red bright blood about 300cc beside him .The fingers are not clubbed ,there is no evidence of nicotine staining,The venous pressure is not elevated, There are no palpable LN.The trachea is central with impaired percussion note bilaterally .breath sounds are reduced bilaterally with crepitation over all the chest.
CXR looks like TB
ESR140
HIVpositive
Diagnosispulmonary TB+ HIV +ve
7. Case4
80 year/M
Referred from dentitionhospital
AS hemoptysis for workup
Old manisnot breathless at rest ,The fingers are not clubbed ,there is no evidence of nicotine staining,The venous pressure is not elevated, There are no palpable LN,
There is ulcerated bleeding mass on the anterior tip of the tong. Chest normal
CXRnormal
Sputum ve for AAFB
Diagnosisas pseudohaemoptsis
8. Haemoptysis is the coughing of blood originating from the respiratory tract below the level of the larynx. Haemoptysis should be differentiated from:
Haematemesis - vomiting of blood from (GI) tract.
Pseudohaemoptysis - where a cough reflex is stimulated by blood not derived from the lungs or bronchial tubes. This may be from the oral cavity or nasopharynx or following aspiration of haematemesis into the lungs.
9. Classifications of severity vary:
10. Massive haemoptysis has been arbitrarily defined as a loss of between 100-600 ml blood over 24 hours. It is a life-threatening medical emergency. This highly variable amount is based on the fact that the anatomic dead space in most adult is 100-200ml.
11.

Vascular Anatomy of the Lung:

12. The pulmonary and bronchial circulation