URINARY CALCULI ANALYSIS

Renal calculi (kidney stones)

- May form in the calyces and pelvis of the
kidney, ureters, and bladder.

Lithiasis
- The formation of renal calculi (kidney
stones).

Lithotripsy
- A procedure that uses ultrasonic waves to
crush renal calculi.
Inspection of Calculi
Classification:
● By location Size: ranges from 1 mm to several cm in diameter
● By chemical nature
(Calcium calculi is most common in states) Shapes: spherical, ellipsoidal, tetragonal, or by
descriptive names (mulberry, hempseed, staghorn,
or jackstone).

Colors: white to almost black

Texture: smooth and highly reflective to rough and

covered with large crystals.

Internal structure: Concentric lamination or

bands.

Techniques for Calculi Analysis

Symptoms of Having Kidney Calculi
As stones move into your ureters — the 1. Chemical Analysis
thin tubes that allow urine to pass from your 2. Polarizing Microscopy
kidneys to your bladder — signs and symptoms 3. Radiographic Diffraction
can result: severe pain, vomiting, fever, chills, and 4. Infrared Spectroscopy
blood in urine. 5. Electron Microscopy
Factors Predisposing Calculi Formation Calcium Phosphate Composition

● Metabolic, nutritional, or idiopathic ● Incomplete catabolism of carbohydrates

disturbances (GOUT) ● Isohydria at pH 5.5-6.0
● Endocrinopathy (Hyperparathyroidism) ● Excessive glycogen breakdown
● Urinary obstruction ● Alkaline infection (urea splitting bacteria)
● Infection with urea splitting organisms ● Persistently alkaline urine
● Mucosal changes (Dietary deficiency)
● Extrinsic and environmental factors Uric Acid and Urates
(dehydration, alkali excess chemotherapy)
● GOUT
Calcium Compositions ● Polycythemia
● Leukemia
● Idiopathic hypercalciuria ● Lymphoma
● Primary hyperparathyroidism ● Liver Disease
● Bone disease ● Acid Isohydria
● Excessive milk, alkali, or vitamin D intake ● Theophylline and Thiazide Therapy
● Renal tubular acidosis ● Conditions associated with Rapid Protein
● Sarcoidosis Catabolism
● Berylliosis

Calcium Oxalate Composition

● Oxaluria
● Incomplete catabolism of carbohydrates
● Isohydria at pH 5.5-6.0
● Excessive glycogen breakdown
Cystine Composition

● Transient acute phases of chronic renal

diseases
● Heavy metal nephrotoxicity
● Aminoaciduria
● Renal tubular acidosis syndrome
pH Correlation

Urine pH Favors the

Consistenc formation of:
y

Acid <5.5 ● Uric Acid

● Cystine
● Xanthine
Calculi

Alkaline >7.0 ● Magnesium

ammonium
phosphate
● Calcium
phosphate
calculi

Acid Between ● Calcium

5.5-6.0 oxalate
● Apatite
calculi

Note: Calculi of Magnesium ammonium

phosphate hexahydrate composition are caused by
alkaline infection with urea splitting bacteria.
 DISEASES OF THE KIDNEY
Diuresis
- Basically a physiological process wherein
the kidneys function to balance out the
water content of the body by producing
excess urine.
- Kidneys play a vital role in diuresis.
Glomerular Diseases
Morphologic changes
● Leukocyte Infiltration
- Results from local chemotactic
response or cellular proliferation.
Neutrophils and macrophages.
● Cellular proliferation
- Causes increased number of
epithelial cells, mesangial cells
which compose the capillary
endothelium and accumulate in the
glomerular factors.
● Glomerular basement membrane
thickening
- Deposition of precipitated protein
● Hyalinization of glomeruli
- Results from the accumulation of
homogenous eosinophilic
extracellular material in glomeruli
causing them to lose structural
detail and become sclerotic.
Tubular Diseases
Other Renal Related Diseases

Nephrotic Syndrome vs. Glomerulonephritis

Chronic Renal Failure

Causes
Pathologic:
● Glomerulonephritis
● Interstitial Nephritis
● Tumors
● Transplant rejection
● Congenital disease
Physiologic:
● Hypertension
● Diabetes mellitus
● Chronic urinary tract infections
● Congenital abnormalities
● Vascular disease
● HIV

Progression to ESRD is characterized as

follows:
● Marked decrease in the glomerular
filtration rate (less than 25 mL/min)
● Steadily rising serum BUN and creatinine
values (azotemia)
● Electrolyte imbalance
● Lack of renal concentrating ability,
producing an isosthenuric urine
● Proteinuria
● Renal glycosuria
● Abundance of granular, waxy, and broad
casts, often referred to as a telescoped
urine sediment
Antidiuretic Hormone

➢ Controls water reabsorption by the

distal convoluted and collecting
tubule.
➢ Increased
○ Water resorption will leading
to a small amount of
concentrated urine.
➢ Decreased
○ Induced polydipsia, polyuria,
diuresis with very dilute urine
with low specific gravity.

Adrenal Insufficiency
● Toxic drugs
● Pulmonary disorders
● Cerebral disorders caused by trauma or
neoplasms

Diabetes Insipidus
● Polyuria
● Polydipsia
- Inadequate ADH or inability of the
renal tubules to respond to the
hormone.
Renin Aldosterone
➢ Proteolytic enzyme - A steroid hormone secreted by adrenal
➢ Formed and stored by juxtaglomerular glands.
cells - Regulates salt and water in the body, thus,
➢ Released into the lymph and renal venous having an effect on blood pressure.
blood.
➢ Converts angiotensin to angiotensin Increased Aldosterone:
products stimulating the synthesis of ● Adrenal adenoma
aldosterone in the adrenal. ● Low renin levels
● K+ wastage
Low Plasma Volume, Low Na+ ● Na+ retention
● Stimulates renin secretion, thus, ● Nephrosis
aldosterone release, thus, Na+ retention ● Cirrhosis
and reabsorption, K+ loss ● Heart failure
● H2O retention high extracellular fluid
volume, elevated blood pressure Renin–Angiotensin–Aldosterone System
● Systemic pressure increases, renin - regulates the flow of blood to and within
production decreases, decrease angiotensin the glomerulus.
aldosterone levels - The system responds to changes in blood
● K+ loss stimulates aldosterone secretion, pressure and plasma sodium content that
suppressing renin release, K+ increased if are monitored by the juxtaglomerular
decreases renin and aldosterone apparatus.
- Consists of the juxtaglomerular
Lesions Found In Kidneys cells in the afferent arteriole and
● Leads to increased renin levels the macula densa of the distal
● Increased aldosterone production convoluted tubule.
● Na+, K+ excretion
● Hypertension
 Stool Formation
What is Stool or Feces?
● Waste residue of indigestible material
(cellulose for the last 4 days)
● Bile pigments and salts
● Intestinal secretions including mucus
● Leukocytes that migrate from the blood
● Epithelial cells that have been shedded
● Bacteria and inorganic material (10-20%)
chiefly calcium and phosphates
● Undigested and unabsorbed food
● Normal pH: >7.0
Stool Formation in the Digestive System
Stage Description
Mouth Food enters the alimentary canal
through the mouth. It is chewed
by teeth which break food down
into smaller pieces. The food is
mixed with saliva that contains
enzymes.
Esophagus The fibromuscular tube
connecting the mouth to the
stomach is called the esophagus.
Food is pushed down using a
wave-like muscular motion
called peristalsis.
Stomach The stomach is the muscular
organ where food is mixed with
gastric juices. Gastric juice has a
low pH, meaning it is acidic, and
is used to help digest food and
kill potentially harmful bacteria.
Liver In the digestive system, the liver
produces bile which helps with
the digestion of fats and oils.
Gallbladder The gallbladder is where bile is
stored and concentrated.
Pancreas The pancreas is where biological
catalysts called enzymes are
produced. Digestive enzymes
speed up the breaking down of
large nutrient molecules.
Small The small intestines are made up
Intestine of three parts: the duodenum,
the jejunum, and the ileum.
Here, food is mixed with
digestive enzymes and bile. The
enzymes speed up the digestion
process. Nutrients are then
absorbed into the bloodstream.
Large The large intestines are made up
Intestine of two parts: the colon and the
rectum. In the colon, water is
reabsorbed from the food. Feces
are stored in the rectum until
they are ready to be passed.
Anus Feces leave the alimentary canal
through the anus.
The Fate of Food
Specimen Collection
● Patients should be instructed how to obtain
a proper specimen.
● A specimen container can be any clean,
non-breakable, leak-proof container that is
large enough to contain the specimen.
● Containers that have preservatives for ova
and parasites must not be used to collect
specimens for other tests.
● The type and amount of fecal specimen
depends on the type of test ordered:
○ Fecal Occult Blood, WBCs, or
Qualitative Fat
- Only a small specimen is
required.
- Qualitative fat analysis
requires a 3-day specimen.
● Patients should understand that the
specimen must not be contaminated with
urine or toilet water, which may contain
chemical disinfectants or deodorizers that
can interfere with chemical testing.
● Technologists must be aware
contaminants such as urine, water, paper,
and gel.
● Care must be taken when opening any fecal
specimen to release gas that has
accumulated within the container slowly.
Fecalysis Macroscopic Examination
Color
➢ Brown - normal
➢ Gray - fecal obstruction, barium
➢ Red - blood, food dyes
➢ Black - blood from upper gastrointestinal
tract, iron therapy, charcoal treatment
➢ Green - vegetables, biliverdin
Consistency
➢ Formed - normal
➢ Hard - constipated
➢ Mushy
➢ Watery – diarrhea, steatorrhea
➢ Mucoid
Form
➢ May change due to gastrointestinal
irregularities
➢ Cylindrical - normal
➢ Ribbon-like – intestinal strictures
of ➢ Small, round – constipation
➢ Bulky – steatorrhea
➢ Mucus – colitis, constipation
 Abnormal Fecal Formation

Diarrhea
- Defined as an increase in daily stool weight
Common Indigestions above 200 g, increased liquidity of stools,
and frequency of more than three times per
day.
- Diarrhea lasting less than 4 weeks is
defined as acute, whereas diarrhea
persisting for more than 4 weeks is termed
chronic diarrhea.

1. Secretory Diarrhea
- Caused by increased secretion of
water.
- Bacterial, viral, and protozoan
infections produce increased
secretion of water and electrolytes,
which override the reabsorptive
ability of the large intestine, leading
to secretory diarrhea
- Other causes of secretory diarrhea
are drugs, stimulant laxatives…
 2. Osmotic Diarrhea 3. Increased intestinal motility
- Caused by poor absorption that Parasympathetic nervous activity – stress
exerts osmotic pressure across the Laxatives - castor oil
intestinal mucosa. Cardiovascular drugs – Digitalis
- Maldigestion (impaired food
digestion) and malabsorption Steatorrhea
(impaired nutrient absorption by - fecal fat excretion exceeding 3g/day
the intestine) contribute to osmotic - Detection of steatorrhea (fecal fat) is useful
diarrhea. in diagnosing pancreatic insufficiency and
- Causes of osmotic diarrhea include small-bowel disorders that cause
disaccharidase deficiency (lactose malabsorption.
intolerance), malabsorption (celiac - Appears pale, greasy, bulky, spongy or
sprue), poorly absorbed sugars pasty in consistency and have a very strong
(lactose, sorbitol, mannitol), odor
laxatives, magnesium-containing - can occur in combination with diarrhea
antacids, amebiasis, and antibiotic - can result from either Maldigestion
administration. (decreased levels of pancreatic enzymes or
decreased bile) and Malabsorption (disease
Celiac Disease: Gluten Intolerance that damage the intestinal mucosa)
- Steatorrhea may be present in those with
Gluten either maldigestion or malabsorption
- A substance in wheat, and other grains, conditions and can be distinguished by the
may be found in a variety of foods D-xylose test.
including breads, cakes, cereals, pasta, - D-xylose is a sugar that does not
commercial dairy products, and alcoholic need to be digested but does need
beverages. to be absorbed to be present in the
urine. If urine D-xylose is low, the
resulting steatorrhea indicates a
malabsorption condition.
- A normal D-xylose test indicates
pancreatitis.
- Malabsorption causes include bacterial
overgrowth, intestinal resection, celiac
disease, tropical sprue, lymphoma,
Whipple disease, Giardia lamblia
infestation, Crohn disease, and intestinal
ischemia.
Fecalysis Microscopic Examination Creatorrhea
- increased amount of meat fiber
WBC/ Pus - indicates impaired digestion and or rapid
- infectious or inflammatory intestinal intestinal transit
mucosal wall - rectangular or cylindrical fibers with cross
- ulcerative colitis, dysentery (bacterial), striations
ulcerative diverticulosis, intestinal
tuberculosis

Vegetable Cell
- Sometimes causes confusion with ova,
eggs, cysts, or cell bodies
- Irregular outer margin
- Excess quantity is seen in excess intake of
Fecal Fat vegetables or indigestion
● Sudan III, Sudan IV, Oil red O
- all stains fecal triglycerides
- orange to red in suspension
● Suspension of fecal preparation can also be
placed on a slide with several drops of
ethanol
- stain is added to the slide, wet prep
is shielded with a coverslip and
observed for stained fat globules
- Normal stool : 60 globules /HPO
● 2nd slide: HCL + heat can be added
- can cause free fatty acids to be
stained.
- Increased number of fat globules
normally observed
- Steatorrhea >100 globules/HPO
- large globules 40-80 um
 Chemical Examination

Fecal blood determination

- Early detection of colo-rectal cancer

Melena
- Large amounts of fecal blood 50-
100ml/day that turns stool to black

Occult Blood
- small amounts of fecal blood, 30-
50ml/day

Testing Principles

1. Hemoglobin Reduction Methods

● Principle : based on the reaction of
hemoglobin with (H2O2) Hydrogen
Peroxide an indicator (blue-green
color)
● Other indicators: (sensitive to least)
a. Benzidine (carcinogenic)
b. Ortho Toluidine
c. Guaiac ( most common)
● Interfering factors:
a. False Positive
- diet of rare cooked
meat, some
vegetables (turnips,
Bacteria broccoli), some fruits
- Normal flora (cantaloupes,
- Abundancy may indicate prolonged bananas) drugs
unexamined hours, infection (aspirin)
b. False Negative
- vitamin C, Ascorbic
acid
● Limitations of the examination
a. more than 1 fecal site
needs to be tested
b. If Hgb has been degraded
on long standing or in the
gastrointestinal tract, it's
pseudoperoxidase activity
has been lost and will not
react with the indicator
 2. Hemoquant Test
● Principle: conversion of
non-fluorescent heme to
fluorescent porphyrins
● detects total fecal Hgb (degraded
and non -degraded)
● higher degree of specificity is
obtained as compared to
convention methods thus not
affected by common interfering
substances
3. Immunodiffusion and enzyme
immunoassay
● Principle: using an anti human Hgb
are the most sensitive method
Fetal Hemoglobin in Feces (HbF)
● Newborns may excrete stool containing
blood originating from maternal blood that
was ingested during delivery.
● Maternal RBC
- can be distinguished from fetal Hgb
with the Apt test based on the
alkaline resistance of fetal Hgb
- Fecal suspension made and 5 ml
supernatant mixed with 1 ml of 0.25
mol/l NaOH
● Hb A – adult or maternal – pink to yellow
to brown in 2 minutes
● Hb F – pink color remains
Quantitative Fecal Fat
● 2 days before collection patient should be
put in a normal diet to include adequate fat
and calorie intake
● A 3-6 day fecal collection is obtained
● Test principle: determination of fat content
by either
● Normal Value: 1-6 g/d fecal fat
● Percent fat retention = dietary gram fat –
fecal fat/dietary gram fat
Fecal Carbohydrate Analysis
Osmotic Diarrhea
● When disaccharides are not degraded to
and they retain in the intestines,
monosaccharides become osmotically
active.
● pH 5.0 – 6.0
● Causes:
○ Hereditary disaccharidase
- deficiency is rare
○ Acquired disaccharidase deficiency
- malabsorption disease
(tropical sprue), drug effects
(neomycin)
○ Lactose intolerance
- most common in African
and Asians
Analysis for Disaccharide Deficiency
1. Clinitest
- test for reducing sugars, but not
specific disaccharides are identified.
- Sucrose cannot be detected
2. Oral Tolerance Test
- using specific sugars (lactose,
sucrose)
➢ Normally disaccharides are reduced to
mono (glucose, galactose) in the small
intestine
➢ An increase in patients blood glucose or
galactose 30 mg/dl greater than the fasting
level indicates adequate enzyme activity
Fecal Smear

Preparations
● More or less 5gm of fecal material
● Applicator stick
● Glass slide
● Saline solution
● Microscope
● Disposal bin for applicator stick with
disinfectant/chlorine
● Disposal tank for used glass slide with
disinfectant/chlorine

Kato-Katz Technique
- Used in field work
- Longer time to exam
Iodine Smear - Mass examination
- to detect presence of glycogen by drop of I2 - Detects helminths, soil transmitted
- changing color to bluish black parasites
- Uses preformed format
- Cellulose/cellophane

Fecal Occult Blood Test

● Non –invasive test
● Test for blood that is undetected or hidden
or is not apparent in the feces.
● These blood may come anywhere along the
digestive tract
● Occult blood is often or the only sign that a
person has colo-rectal disease including
colon cancer
 Sputum Analysis

Sputum/Phlegm
- As these mixtures pass through the lower
- Viscous material that is derived from the and upper respiratory tract, they become
lower air passages such as the lungs and contaminated with cellular exfoliators,
bronchi may contain substances such as nasal and salivary gland secretions and
mucus, blood, pus and/or bacteria; it is not normal bacterial flora of the oral cavity.
the saliva that is produced by the glands in
the mouth
- Is a sticky, gel -like liquid secreted by the
Color of Sputum
mucous membranes in the respiratory tract
of humans and mammals.
- It is formed mainly of lipids, glycoproteins,
and immunoglobulins, as well as other
substances.
- Foreign agents (dust, allergens, viruses,
and bacteria) that enter the body through
the respiratory tract. Excess phlegm is
produced as a sign that the body is
fighting some sort of infection.
- The composition and color of phlegm can
vary greatly, its function is generally to
trap from watery to thick or clear to
brownish, depending on the environment
and the state of the body's immune system ● The color of the mucus being coughed out
is generally an indicator as to what kind of
at any given time. infection a person has.
- To lubricate the respiratory and nasal ● Normal mucus from a healthy body is
passages, neutralized by the mucus and typically, but not always, clear in color and
then expelled from the body through generally thin in composition.
coughing or sneezing. While cough ● An irritation of the nasal passageway, such
suppressants may provide relief, they may as one caused by allergies or asthma, may
also suppress the necessary elimination of result in a whiter, thicker mucus. White or
clear mucus may still be present during
immune system waste. the initial stage of the flu but will still be
- This mucus-like secretion may become infectious during that time.
infected, bloodstained, or contain ● Constantly coughing up white or clear
abnormal cells that may lead to a mucus could indicate a mild viral
diagnosis infection, most of which heal
- Tracheobronchial sections are an an independently within five to seven days.
inconstant mixture of plasma, water,
electrolytes and mucin
Odor of Sputum

Usually. no odor presents in normal and

pathological sputum if bacterial decomposition has
taken place within the body or after expectoration,
a variety of odor will be present.
Appearance of Sputum Miscellaneous Findings in Sputum

● Purulent, mucopurulent, mucoid (mucus, Foreign Bodies

cell debris, WBC) - In children, they can be any small object a
● Blood stained (Streptococcus pneumoniae) child may place into his mouth. In adults,
● Saliva (an indicator of URT contamination) they are either food particles or gastric
● Bloody contents aspirated during a convulsion,
● Rusty colored during intoxication or operative anesthesia.
● Purulent
● Foamy white
● Frothy Pink

Distinction Between Mucus and Phlegm

● Mucus is a normal protective layering

around the airway, eye, nasal turbinate,
and urogenital tract.
● Mucus is an adhesive viscoelastic gel
produced in the airway by submucosal
glands and goblet cells and is principally
water.
● Contains high-molecular weight mucous
glycoproteins that form linear polymers
● PHLEGM is more related to disease than is
mucus.
● Phlegm is a secretion in the airway during
disease and inflammation.
● Phlegm usually contains mucus with
bacteria, debris, and sloughed-off
inflammatory cells.
● Once phlegm has been expectorated by a
cough it becomes SPUTUM.
Tubercle Bacilli

Excessive Phlegm Production

There are multiple factors that can contribute to Illness

an excess of phlegm in the throat or larynx. - During illnesses like the flu, cold, and
pneumonia, phlegm becomes more
● Vocal abuse: Vocal abuse is the misuse or
excessive as an attempt to get rid of the
overuse of the voice in an unhealthy
bacteria or viral particles within the body.
fashion such as clearing the throat, yelling,
screaming, talking loudly, or singing
Acute Bronchitis
incorrectly.
- A major symptom of acute bronchitis is an
● Clearing the throat: Clearing the throat
excess amount of phlegm and is usually
removes or loosens phlegm but the vocal
caused by a viral infection, and only
cords hit together causing inflammation
bacterial infections, which are rare, are to
and therefore more phlegm.
be treated with an antibiotic.
● Yelling/screaming: Yelling and screaming
both cause the vocal cords to hit against
Hay Fever, Asthma:
each other causing inflammation and
- In hay fever and asthma, inner lining in
phlegm.
bronchioles become inflamed and create an
● Nodules: Excessive yelling, screaming, and
excess amount of phlegm that can clog up
incorrect singing as well as other vocal
air pathways.
abusive habits can cause vocal nodules.
See vocal fold nodule for more
information on nodules.
● Smoking: Smoke is hot, dry, polluted air
which dries out the vocal cords. With each
breath in of smoke, the larynx is polluted
with toxins that inhibit it from rehydrating
for about 3 hours. The vocal cords need a
fair amount of lubrication and swell from
inflammation when they do not have
enough of it. When the vocal folds swell
and are inflamed, phlegm is often created
to attempt to ease the dryness.
● Air Pollution: In studies of children, air
pollutants have been found to increase
phlegm by drying out and irritating parts
of the throat.
Parasites and Crystals in Phlegm

Sputum Collection

1. The cup is very clean. Don’t open it until

you are ready to use it.
2. As soon as you wake up in the morning
(before you eat or drink anything), brush
your teeth and rinse your mouth with
water. Do not use mouthwash.
3. If possible, go outside or open a window
before collecting the sputum sample. This
helps protect other people from TB germs
when you cough.
4. Take a very deep breath and hold the air for
5 seconds. Slowly breathe out. Take
another deep breath and cough hard until
some sputum comes up into your mouth.
5. Spit the sputum into the plastic cup
6. Keep doing this until the sputum reaches
the 5 ml line (or more) on the plastic cup.
This is about 1 teaspoon of sputum.
7. Screw the cap on the cup tightly so it
doesn’t leak.
8. Wash and dry the outside of the cup.
9. Write on the cup the date you collected the
sputum. Tip: If you cannot cough up
sputum, try breathing steam from a hot
shower or a pan of boiling water. WHY IS SPUTUM TEST NECESSARY
10. Put the cup into the box or bag the nurse - The laboratory will test the sputum for TB germs.
gave you. - If you are already taking medicine for TB,
11. Give the cup to your clinic or nurse. You checking your sputum is the best way to tell if the
can store the cup in the refrigerator medicine is working.
overnight if necessary. Do not put it in the - To be sure the test is accurate, you must cough up
freezer or leave it at room temperature sputum from deep inside your lungs.
Hemoptysis Various rare blood vessel problems
may also cause bleeding into the
- Coughing out of blood. lungs or airways.
- Expectoration (ejection of blood from the
throat or lungs by spitting, coughing or
hawking) of blood which is derived from
the lungs or bronchi and arises as a result
of pulmonary (relating to the lungs) or
bronchial hemorrhage (an acute bleeding
from the lung).

Causes of Hemoptysis:

● Infection of the airways (bronchi), called Pulmonary Embolism

acute bronchitis.
● Infection of the lung tissue, pneumonia, - a serious, potentially life-threatening
are perhaps the most common cause of condition. It is due to a blockage in a blood
mild bouts of coughing up blood. vessel in the lungs. The main symptoms
● Infection anywhere in the airways may are usually chest pain and breathlessness,
potentially cause hemoptysis. Typically, but hemoptysis may also occur.
the blood is mixed up with spit (sputum).
● Other symptoms related to the infection
will normally be present Such as high
temperature (fever) and cough. Typically,
the hemoptysis goes when the infection
clears. Often no further tests are needed if
the hemoptysis is clearly linked to the
infection and then goes.
● Objects breathed in (inhaled) and injury
(trauma)
- Inhaled objects can cause damage
to an airway and lead to
hemoptysis. For example, an
inhaled peanut or small toy may
sometimes be a cause in small
children. Other types of injury to a
lung or airway can cause
hemoptysis.
● Heart and blood vessel problems
- Severe heart failure can cause a
build-up of fluid in the lungs. The
main symptom is usually
breathlessness but the sputum may
become frothy and bloodstained.
Treatment for Hemoptysis:
Bronchial Artery Embolization
- A doctor advances a catheter through the
leg into an artery supplying blood to the
lungs. By injecting dye and viewing the
arteries on a video screen, the doctor
identifies the source of bleeding. That
artery is then blocked, using metal coils or
another substance. Bleeding usually stops,
and other arteries compensate for the
newly blocked artery
● Vomiting of bright red blood
● Profuse bleeding
● Coffee ground material – altered blood
converted to acid hematin by gastric HCl
● Bleeding due to above ligaments of
TREITZ
● Maybe false due to swallowed blood from
the nose, mouth pharynx
● TRUE due to bleeding from esophagus to
duodenojejunal function

Bronchoscopy

- Tools on the end of the endoscope can be

used to treat some causes of coughing up
blood. For example, a balloon inflated
inside the airway may help stop bleeding.

● Surgery. Coughing up blood, if severe and

life-threatening, may require surgery to
remove a lung (pneumonectomy).
● Treatments for hemoptysis should also
address the underlying reason for
coughing up blood. Other treatments for
people coughing blood may include:
● Antibiotics for pneumonia or tuberculosis
● Chemotherapy &/or radiation for lung
cancer
● Steroids for inflammatory conditions

Hematemesis