L 6 .approach to cough and hemoptysis

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Text of L 6 .approach to cough and hemoptysis

  1. 1. Cough and Hemoptysis DR.Bilal Natiq Nuaman,MD C.A.B.M. ,F.I.B.M.S. ,D.I.M. ,M.B.Ch.B. 2016-2017
  2. 2. Cough Definition: A Cough is a forced expulsive manoeuvre, usually against a closed glottis and which is associated with a characteristic sound It is caused by stimulation of sensory nerves in the mucosa of the pharynx, larynx, trachea bronchi. and Cough is the single most common respiratory complaint for which patients seek care
  3. 3. Classification of Cough Acute Cough = < 3 Weeks Duration Subacute Cough 3-8 Weeks Duration Chronic Cough > 8 Weeks Duration
  4. 4. Acute Cough 8 weeks 2-Character : Bovine with Hoarsness----Left recurrent laryngeal nerve palsy causing left vocal cord paralysis due to CA Lung Barking with Hoarsness and Stridor -----Acute Epiglottitis, Laryngitis , CA Larynx Wheezy ------COPD , Asthma
  5. 9. 2-Amount of Sputum How much sputum is coughed up each day ? Is it a small (a teaspoonful) or large (a teacupful) amount? Bronchiectasis-------- a long history of large amount of purulent sputum to be coughed up mainly in morning on changing posture . Pulmonary Oedema ------ Large volumes of watery frothy sputum with a pink tinge in an acutely dyspnic patient .
  6. 10. Hemoptysis Coughing up blood, irrespective of the amount, is an alarming symptom and patients nearly always seek medical advice. A history should be taken to establish that it is true hemoptysis and not hematemesis, or gum or nose bleeding. Hemoptysis must always until this is excluded . be assumed to have a serious cause It Massive Hemoptysis: is coughing of about 600ml blood/24 h
  7. 11. History A history of repeated small haemoptysis is highly suggestive of bronchial carcinoma. Fever, night sweats and weight loss suggest tuberculosis. Pneumococcal pneumonia often causes 'rusty'-coloured sputum but can cause frank haemoptysis, as can all suppurative pneumonic infections including lung abscess. Bronchiectasis can cause catastrophic bronchial haemorrhage, pulmonary thromboembolism is a common cause of haemoptysis and should always be considered.
  8. 12. Thank you