MLA Domain 5 · Presentation
Haemoptysis
8 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.
classic presentation · 3
Haemoptysis/persistent cough/weight loss in a smoker → urgent 2-week-wait referral + urgent CXR (NICE NG12)
TB meningitis / disseminated (miliary) TB → urgent treatment; airborne isolation for suspected active pulmonary TB
Pulmonary-renal syndrome (haemoptysis + AKI/active sediment) → rapidly progressive glomerulonephritis → emergency immuno
recognised feature · 4
Massive haemoptysis → emergency (bronchial artery embolisation)
Established Eisenmenger CONTRAINDICATES shunt closure (the shunt is now offloading the right heart) — the window was mis
AF with systemic embolism (stroke) — anticoagulate; mitral stenosis AF needs warfarin, not a DOAC, if rheumatic/moderate
Haemodynamic instability (massive PE) → consider thrombolysis; pregnancy (alters imaging choice)
differential of the above · 1