Maja Udovcic MD
Sudheer Penupolu MD
Robert W. Viggiano MD
Lewis J. Wesselius MD
Department of Pulmonary Medicine
Mayo Clinic Arizona
Scottsdale, AZ
History of Present Illness
A 51 year old African-American woman was admitted from the emergency department with hemoptysis. She had blood tinged sputum earlier in the day followed by about ½ cup of hemoptysis which led her to seek care.
PMH, SH, FH
She is known to have stage IV sarcoidosis with bronchiectasis and cavitation. A right upper lobectomy was performed in 1996 and embolization of
3 left bronchial arteries in 2011 for hemoptysis. She has a history of anaphylaxis with iodinated radiocontrast dye. However, no reaction occurred with premedication in 2011. She also has a history of asthma, but has been out of her medications for several days. Since this time she has noted increased cough. She is a nonsmoker and a Jehovah’s Witness. Her family history is noncontributory.
Medications
Physical Examination
VS: 36.9°C, 106 beats/min, 135/83 mm Hg, 26 breaths/min, SpO2 100% on room air
General: She is in no acute distress.
Respiratory: coarse breath sounds with scattered wheezing, inspiratory crackles, and diminished air movement throughout
Which of the following laboratory tests should be ordered? (click on correct answer to move to next panel)
Reference as: Udovcic M, Penupolu S, Viggiano RW, Wesselius LJ. February 2014 critical care case of teh month: a rush of blood. Southwest J Pulm Crit Care. 2014:8(2):79-87. doi: http://dx.doi.org/10.13175/swjpcc165-13 PDF