Quit Smoking

Patient: Ali, 57 years
1. Heavy smoker (past 40 years)
  1. Chronic Bronchitis (diagnosed 8 yrs ago)
    1. Presentaion:
      1. Unexplained weight loss
      2. Hemoptysis (increased in morning)
        Causes:
        COPD
        Drugs
        Lung abscess
        Cystic fibrosis
        Lung cancer
        Mitral valve stenosis
        TB
        Pulmonary embolism
        Parasite infection
        Abdominal muscle
        Chest trauma
      3. Persistent productive cough
      4. SOB on exertion (past 3 years) and on rest (past 2 months)
      5. Slightly cyanosed, anxious
  2. Nicotine Dependence
2. Diganosis:
  1. LUNG CANCER
    1. Classification and types
    2. Risk factors and causes:
      1. Occupation
        Miners
        Heavy metal workers
      2. Smoking/tobacco
      3. Second-hand smoke
      4. Family history
      5. Radon gas
      6. Aging
      7. Other illness (COPD)
      8. Pollution
    3. Presentation:
      1. Cough
      2. Weight loss
      3. Hemoptysis
      4. Pancost tumor:
        Horner's syndrome
        Ptosis
        Miosis
        Ipsilateral anhydrosis
        Brachial plexus involvement
        Cervical rib destruction
      5. Paraneoplastic syndrome
        Digital clubbing
        Eaton-lambert syndrome
        Ectopic hormone secretion
        ACTH
        ADH
        GH
    4. Investigations:
      1. Sputum cytology
      2. Chest X-ray
        will show Pleural Effusion
        Classifications:
        Transudate
        Hydrothorax
        CHF
        Exudate
        Microbial Invasion
        Empyema
        Cancer
        Pulmonary Infection
        Viral Pleuritis
        Hemothorax
        Ruptured intrathoracic aortic aneurysm
        Chylothorax
        Obstruction of the major lymph ducts
        Analysis of pleural fluid
        help diagnose the cause of accumulation of fluid
        Done by initial test:
        Fluid protein
        Albumin
        LD level
        Cell count
        Management:
        Pleural drain
        Pleurodesis
        Thoracocentesis
        Tube thoracostomy
      3. CT Scan
      4. Biopsy
    5. GRADING + STAGING
      1. Grading:
        level of aggressiveness of a tumor
        classified into grades I, II, III, IV in order of increasing anaplasia
      2. Staging
        Assessment of the spread
    6. Treatment of lung cancer
Anatomy of the posterior mediastinum

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	Criado por shahid alzaghari aproximadamente 7 anos atrás