Quit Smoking

Quit Smoking

1. Patient: Ali, 57 years

   • Heavy smoker (past 40 years)
     • Chronic Bronchitis (diagnosed 8 yrs ago)
       • Presentaion:
         • Unexplained weight loss
         • 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
         • Persistent productive cough
         • SOB on exertion (past 3 years) and on rest (past 2 months)
         • Slightly cyanosed, anxious
     • Nicotine Dependence
   • Diganosis:
     • LUNG CANCER
       • Classification and types
       • Risk factors and causes:
         • Occupation
           • Miners
           • Heavy metal workers
         • Smoking/tobacco
         • Second-hand smoke
         • Family history
         • Radon gas
         • Aging
         • Other illness (COPD)
         • Pollution
       • Presentation:
         • Cough
         • Weight loss
         • Hemoptysis
         • Pancost tumor:
           • Horner's syndrome
             • Ptosis
             • Miosis
             • Ipsilateral anhydrosis
           • Brachial plexus involvement
           • Cervical rib destruction
         • Paraneoplastic syndrome
           • Digital clubbing
           • Eaton-lambert syndrome
           • Ectopic hormone secretion
             • ACTH
             • ADH
             • GH
       • Investigations:
         • Sputum cytology
         • 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
         • CT Scan
         • Biopsy
       • GRADING + STAGING
         • Grading:
           • level of aggressiveness of a tumor
             • classified into grades I, II, III, IV in order of increasing anaplasia
         • Staging
           • Assessment of the spread
       • Treatment of lung cancer

2. Anatomy of the posterior mediastinum

Imagens e arquivos do mapa