A 60-year old patient with a past history of treated pulmonary TB presents with massive hemoptysis. What is the most likely cause for hemoptysis?
Correct Answer: Aspergilloma
Description: Causes of HEMOPTYSIS A:Infections:y 1.viral bronchitis 2.chronic bronchitis super infected with streptococcus,hemophilus etcwhich increase airway inflammation and potential for bleeding. 3.bronchiectasis(with recurrent infections) LEADING CAUSE OF MASSIVE HEMOPTYSIS AND SUBSEQUENT DEATH. 4.Tuberculosis Development of cavity is frequent source of bleed Erosion of pulmonary aery(Rasmussen aneurysm) 5.others like Nocardia,non tb mycobacterium,aspergillus in pre existing cavities, pulmonary abscess,,paragonimiasis. B:vascular 1 pulmonary edema 2.pulmonary embolisms 3.pulmonary a v malformations 4.aoo bronchial fistula 5.diffuse alveolar hemorrhage cause significant bleed in to lung but NOT PRESENT AS HEMOPTYSIS CAUSES OF DAH:SLE,COCAINE TOXICITY,PULMONARY RENAL SYNDROME BY ANTI GBM,Granulomatosis with polyangitis.(these people also have hematuria). C:MALIGNANCY Bronchigenic carcinoma(any histology). Carcinoid Metastasis from melanoma ,sarcoma,adenocarcinoma of breast and colon. Kaposi sarcoma in hiv patients D: MECHANICAL and others Diagnostic and therapeutic procedures Pulmonary endometriosis Foreign body Coagulopathy. Source:HARRISON 20TH EDITION
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