MEDICINE Contents Chapter .No TOPICS CARDIO 2, WES enpbarmneot TEN PVT. LT INFECTION DISEASES D, HEMATOLOGYDIAMS MEDICINE RESPIRATORY SYSTEM Manifestations of lung disease 41. Hemoptysis: Expectoration of blood from respiratory tract. ‘Most common source of hemoptysis is from bronchial artery ‘Most common cause is TB Massive - » 500 mi/d (or) rate of blood lass. pseudchaemoptysis - it is due to pigment, prodigiosin produced by gram-negative organism- Serratia marcescens. Endemic hemoptysis - infection with lung fluke (Poragonimus westermani) ‘Spurious hemoptysis - hemoptysis secondary to upper respiratory tract infection, above the level of larynx. For massive hemoptysis- rigid bronchoscopy is preferable to fibreoptic ‘ronchoscopy because of: 1. Better airway control 2. Greater suction capability Management Bronchoscopy with localization of lesion, followed by embolisation of the of involved vessels in severe cases. 2. Dyspnea or shortness of breath Receptors involved in mechanism of dyspnea 1. “T receptors - situated at alveole-copillary junction 2. Chemo receptors - in carotid A. and aorta 3. Cortical centers 4. Afferent fibers in phrenic rerves Causes ‘Asthma/ COPD, pneumonia, Preumethorax, pulmonary embolus, ARDS, SARS, sleep aprea, left ventricular failure or gestrointestinal reflux disease. ‘Orthopnea - Dyspnea upon assuming Supine position 1. Congestive Heart Failure 2, Bilateral diphragmatic paralysis ‘Trepopnea: - Dyspnea oceurring in lateral decubitus position Unilateral respiratory diseose like Pleural effusion, preumothrorox. Platypnea: dyspnea occurs in upright position ‘A-V Shunts at the base of the lung leading to alterations in ventilation perfusion 3. Clubbing ‘Structural changes in base of nail, softening of nail bed, and logs of normal 150-degree angle between the nail and cuticle. Later the distal phalanx becomes more convex and thicker and its thickness exceeds the thickness of DIP. Later chronic proliferative periostitis of terminal phalanx occurs known os Hypertrophic pulmonary osteo-arthropahty. Pathology Hypoxia causes release of platelet-derived growth factor, The condition is resolvable. 4. Cyanosis Results when amount of deoxyhoemoglabin exceeds >5g/dl { central cyanosis Peripheral cyenosis Tongue end extremities blue Extremities blue Non responsive to oxygen administration Responsive to oxyen admin as eause is poor Due to central mixing peripheral circulation 5. Cough Productive cough: Suppurative lung disease, COPD, tuberculosis Bovine cough: cough with loss of explosive nature, example Tumors pressing on recurrent laryngeal N. Barking cough: found in epiglottal involvement. DIAMS DELHI INSTITUTE FOR ADVANCED MEDICAL STUDTES 24 HOURS HELPLINE : 9891436206, 9891334352