Coughing up blood with rapid weight loss

LBM 6 M. 11
Step 1
Miosis and ptosis (horners syndrome)
Miosis Small pupil ; ptosis palpebra cant open as a normaly
Facial anhidrosis
Step 2
1.
2.
3.
4.
5.

Why the man feels shortness breath and pain in lower chest?
Why the man cough with phlegm and sometimes with hoarse voice?
Why the man cough up blood?
Why the appetite to be wight loss?
Why when the physical examination founded with facial anhidrosis, miosis
and ptosis?
6. What is the differential diagnose from the scenario?
7. Why when he run out to the medicine, he suffered from cough and shortness
again?
8. What is the the treatment from the scenario?
9. What is the ethiology and phatogenesis the diagnose?
10.What is clinical manifestation?
11.What is risk factor?
12.What is classification of diagnose?
Step 3
1. Why the man feels shortness breath and pain in lower chest?
Answer :
Pain : Because of abnormality from the cell in the lung hyperplasia and
metaplasia caused by expose of cigarrete or polutan result in onset mass or
tumor in the lung tumor infection the wall chest pressing chest wall
cause damage destruction cause pain chest wall
Shortness breath : hyperlasia cell in bronkus can obstruck broncus oxigen
in lung cant exit in normaly
Restrictif cause decrease the complain of lung
2. Why the man cough with phlegm and sometimes with hoarse voice?
Answer :
expose of cigarrete or polutan result iritasin pain in n. Laryngeus
reccurens hoarse voice
there are mass press the n. Laryngesus reccurens hoarse voice
3. Why the man cough up blood?
Answer :
Hyperplasia press the vascular ruptur of the vascular hemorrhage in
the lung cough up blood
4. Why the man lossing appetite which cause weight loss?
Answer :
The nutrition for the body eat for the mass, so the body wight loss
Lectin hormone that rule the appetite.

5. Why when the physical examination founded with facial anhidrosis, miosis
and ptosis?
Answer :
6. What is the differential diagnose from the scenario?
Answer :
Lung neoplasm : opaque mass (in other diagnose)
TBC
brochiectasis
7. Why when he run out to the medicine, he suffered from cough and shortness
again?
Answer :
The treatment just for the symptoms
8. What is the ethiology and phatogenesis the diagnose?
Answer :
ethiology
Polutan
Cigarrete
Expose from chemical compound, ex : asbes
Genetic factor occur the deletion in crhomosom P53
Reinflamation
Phatogenesis
When we respiration contain polutan, chemical lung expose in cronic time
inhalation respiration iritation lung carcinogenic cell there are 3
level
1. pre-carcinoma
The cell to be big and loss the cilia function cell goblet and seromucus
become hypersecretion
2. Ca in situ
3. invasisve carsinoma
9. What is classification of diagnose?
Answer :
Small cell lung cancer (SCLC) domain from smal cells than contain
mucus with little cromatin
Non SCLS adenocarcinoma squamos cell
10.What is clinical manifestation?
Answer :
Different in
Anamnesis :

Hemoptoe
Anoreksia
Fever
Malaise
Tired

Muscle wikness
Decrease of weight

physical examination :

Miosis and ptosis

Sterm fremitus low
Perkusi : pekak
Facial anhidrosis

diagnostic examination
foto rontgen : opaque mass
11.What is risk factor?
Answer :
Smoking
Polution
Job with expose chemical
12.What is the the treatment from the scenario?
Answer :
Supportif treathment
Vitamin and mineral
Medicine for increase the appetite
Symptomatic treathment

For the pain, shortness breath given paliative radiation

For carcinoma the last stadium given reduce the pain, ex : morfin inj.,
petidine

For carcinoma

Surgery
Radiotherapy
Cemotherapy
Combination

Other treathment

Imunotherapy and psycotherapy

Step 4
Ethiology phatophysiology (short explain) clinical manifestation fever,
hemoptisis, horners syndrome physical examination diagnostic
examination lung neoplasm treathment