Hemoptysis: Difference between revisions
(Created page with "==Workup== 0) Icon 1) CBC 2) Chem 7 3) Coags 4) T&S/T&C 5) UA (autoimune) 6) ECG (pulm HTN/PE) 7) CXR (30% will be nl) 8) Consider D-Dimer/Spiral CT 9) IVF/blood/corre...") |
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VI. Misc | VI. Misc | ||
A. | A. Crack cocaine | ||
B. Iatrogenic | B. Iatrogenic | ||
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Bold: Most common in US | Bold: Most common in US | ||
==Treatment== | ==Treatment== | ||
Revision as of 19:18, 31 May 2011
Workup
0) Icon
1) CBC
2) Chem 7
3) Coags
4) T&S/T&C
5) UA (autoimune)
6) ECG (pulm HTN/PE)
7) CXR (30% will be nl)
8) Consider D-Dimer/Spiral CT
9) IVF/blood/correct coagulop as nec
DDx
I. Airway
A. Bronchitis (acute/chronic)
B. Bronchietctasis
C. Neoplasm (primary/met)
D. Trauma
E. Foreign body
II. Parenchymal Dz
A. Infectious
1. TB
2. PNA
3. Fungal
4. Abcess
B. Autoimmune
1. Goodpasture's
2. SLE
3. Wegener's
4. Pulmonary Hemosiderosis
III. Vascular
A. PE
B. AV malformation
C. Pulm HTN
D. Aortic dissection
IV. Hematologic Dz
A. Coagulopathy
B. DIC
C. Platelet dysfx
D. Thrombocytopenia
V. Cardiac
A. Mitral stenosis
B. Tricuspid endocarditis
VI. Misc
A. Crack cocaine
B. Iatrogenic
C. Tracheal-arterial fistula
Bold: Most common in US
Treatment
MASSIVE = >100-500cc/day
- angle head down with affected lung low
- consider angio embolization
- intubate with >8.0 (for bronch)
Disposition
ADMISSION
1) Massive
2) Minor + high risk of massive bleed
Source
3/19/06 DONALDSON (adapted from Rosen)