Medical history (history of illness) represents an important component in the diagnosis of hemoptysis (hemoptysis). Family history What is the general health of your relatives? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to harmful working substances in your profession? Current medical history/systemic medical history (somatic … Coughing Up Blood (Hemoptysis): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Pulmonary AV malformation – malformations in the vascular system of the lungs. Respiratory system (J00-J99 Bronchiectasis (synonym: bronchiectasis) – persistent irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways) that may be congenital or acquired; symptoms: chronic cough with “mouthful expectoration” (large-volume triple-layered sputum: foam, mucus, and … Coughing Up Blood (Hemoptysis): Or something else? Differential Diagnosis
Pathogenesis (development of disease) In pulmonary edema, a cardiac cause can be distinguished from a noncardiac cause. Fluid leakage from the pulmonary capillaries (small pulmonary vessels) into the interstitium (intercellular space; interstitial pulmonary edema) and/or alveolar space (intraalveolar pulmonary edema) occurs in pulmonary edema. The cause may be increased pulmonary capillary pressure, decreased colloid osmotic … Pulmonary Edema: Causes
General measures Seated storage Oxygen administration (target sO2 (oxygen saturation) > 90%), non-invasive/invasive ventilation if necessary. Sedation (tranquilization) Cardiac (heart-related) pulmonary edema: preload reduction, increase in cardiac pump function (see therapy heart failure/cardiac insufficiency). Toxic pulmonary edema: if necessary, extracorporeal membrane oxygenation (ECMO); intensive care technique in which a machine partially or completely takes over … Pulmonary Edema: Therapy
In emphysema – colloquially called pulmonary hyperinflation – (synonyms: Pulmonary hyperinflation; senile emphysema; asthma emphysema; atrophic emphysema; bullous giant cyst of the lung; bullous emphysema; bullous emphysema; chronic emphysema; chronic emphysema; unilateral emphysema; unilateral pale lung; emphysema; emphysema pulmonum; emphysema asthma; emphysema vesicles; emphysema in old age; emphysema thorax; vitreous emphysema; interlobular emphysema; emphysema; McLeod … Pulmonary Hyperinflation (Emphysema)
Medical history (history of illness) is an important component in the diagnosis of emphysema (pulmonary hyperinflation). Family history Is there a history of lung disease in your family? Social history What is your profession? Are you exposed to harmful working substances (gases, dusts) in your profession? Current anamnesis/systemic anamnesis (somatic and psychological complaints). What symptoms … Pulmonary Hyperinflation (Emphysema): Medical History
Respiratory System (J00-J99). Bronchial asthma Bronchiectasis (synonym: bronchiectasis) – persistent irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways) that may be congenital or acquired; symptoms: chronic cough with “mouthful expectoration” (large-volume triple-layered sputum: foam, mucus, and pus), fatigue, weight loss, and decreased exercise capacity Bronchiolitis – inflammation of the small bronchi. Chronic rhinosinusitis … Pulmonary Hyperinflation (Emphysema): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by emphysema (pulmonary hyperinflation): Respiratory system (J00-J99) Respiratory insufficiency – inability of adequate gas exchange. Recurrent (recurring) respiratory tract infections. Pneumothorax – collapse of the lungs due to the presence of air in the gap between the lung and pleura. Cardiovascular … Pulmonary Hyperinflation (Emphysema): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [barrel thorax (shape of chest resembles a barrel), drumstick fingers (conspicuous thickening of terminal phalanges), watch glass nails (bulging … Pulmonary Hyperinflation (Emphysema): Examination
1st-order laboratory parameters-obligatory laboratory tests. Determination of alpha-1-antitrypsin – should be performed especially in younger and nonsmoking individuals. Laboratory parameters of the 2nd order – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) … Pulmonary Hyperinflation (Emphysema): Test and Diagnosis
The following symptoms and complaints may indicate pulmonary edema: Dyspnea (shortness of breath)-at first, only on exertion. Rales (RG) Tachypnea – accelerated breathing. Central cyanosis – bluish discoloration of skin and central mucous membranes/tongue in the absence of oxygen. Cough, bloody foam Cold sweats
Therapeutic target Improvement of symptomatology Therapy recommendations Therapy is based on the cause of the disease If necessary, antibiosis (antibiotic therapy). If necessary, diuresis (promotion of urine excretion by medication). See also under “Further therapy” due topleural puncture/thoracic drainage or suction-irrigation drainage for pleural empyema (accumulation of pus (empyema) within the pleura). Further notes In … Pleural Effusion: Drug Therapy
