Definition | Treatment | Management of Disease | Diagnosis | Symptoms | Etiology | Pathophysiology | Procedure



Pulmonary tuberculosis is a disease of chronic bacterial infection caused by mycobacterium tuberculosis, an acid-fast bacilli are transmitted through the air. The disease is characterized by granuloma formation in infected tissues.

Patients with tuberculosis in the Asian region continues to grow. So far, Asia including the region with the highest spread of tuberculosis in the world. Every 30 seconds, there was one patient in Asia died from the disease. Eleven of the 22 countries with the highest numbers of TB cases are in Asia, including Bangladesh, China, India, Indonesia, and Pakistan. Four of five patients with TB in Asia, including the productive age group.


Tuberculosis is caused by TB germs are mycobacterium tuberculosis measuring 0.3 x 2-4 cm. The nature of this bacteria is aerobic is more like living in a high tissue oxygen levels and also in cells that are dormant bacilli is not active but if the bacilli out of the cell will proliferate, the patient will experience a recurrence. Germs more resistant to acid more and more resistant to chemical and physical disorders, can not be seen by the naked eye, die in boiling water, easily killed when exposed to sunlight, survival in a humid room, can multiply in the cells (intra-cell and outside cell / extracellular). There are several factors that can influence the occurrence of TB infection, malignancy Namely tuberculosis bacillus. The number of bacilli are quite a lot, the source of infection, decreased body resistance caused by several factors of heredity, age, poor nutrition and diabetes mellitus.

Signs and Symptoms

A. Fever
Subfebris resemble influenza are fever, but sometimes the heat loss can reach 40-41° C. The first fever attack may recover briefly, but then can come back. This situation is greatly influenced by the immune system of patients and severity of infection of tuberculosis germs that enter.

B. Coughing / coughing up blood
Coughing occurs because of irritation of the bronchi, the nature of starting from dry cough (non - productive) then after the onset of inflammation to be productive (produces sputum). Circumstances are such as cough up blood occurs cavity, but the data also occur in the bronchial wall ulceration.

C. Asphyxiate
In bringan disease (emerging) has not felt shortness of breath. Shortness of breath will be found in the disease is advanced, which already includes the infiltration of the lungs.

D. Chest pain
Chest pain occurs when infiltration had come to the pleura, giving rise to pleurisy. Both pleural friction occurs when patients withdraw or release the breath.

E. Malaise
Symptoms of malaise found in the form of intake is inadequate, the more lean body, headache, chills, muscle aches, night sweats, etc.. Increasingly severe symptoms of this malaise is intermittent and occurs regularly.

  • Complications are often experienced by people with TB are as follows:
  • Hemoptysis
  • Collapse of the lobe
  • Pneumothorax
  • Pleural effusion
  • Bronchiectasis
  • Fibrosis
  • The spread of infection to other organs such as brain, bones, joints, kidneys, and others.
  • Cardio pulmonary insufficiency or decreased function of the heart and lungs so that oxygen levels in the blood is low.

Lung Cancer Prevention

There is no sure way to prevent lung cancer, but you can reduce the risk if you:

No smoking. If you have never smoked, do not start. Talk with your kids not to smoke so they could understand how to avoid the major risk factors of lung cancer. Many smokers start smoking in their teens. Start a conversation about the dangers of smoking with your children early so they know how to react to peer pressure.
Stop smoking. Stop smoking now. Quitting smoking reduces the risk of lung cancer, even if you have smoked for many years. Consultation with your doctor about smoking cessation strategies and assistance that can help you quit. Options include nicotine replacement products, medication and support groups.
Avoid cigarette smoke. If you live or work with smokers, encourage him to stop. At the very least, ask him to smoke outside. Avoid areas where people smoke, such as bars and restaurants, and choose the smoke-free area.

Your home radon test. Check the levels of radon in your home, especially if you live in an area where radon is known to be a problem. High radon levels can be improved to make your home safer. For information on radon testing, call the health department.
Avoid carcinogens in the workplace. Precautions to protect themselves from exposure to toxic chemicals in the workplace. Your company must notify you if you are exposed to hazardous chemicals in your workplace. Follow these precautions your boss. For example, if you are given a mask for protection, always wear it. Ask your doctor what else can you do to protect themselves in the workplace. Risk of lung damage from carcinogens is increased if you smoke.
Eating foods containing fruits and vegetables. Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as they may be dangerous. For example, the researchers hope to reduce the risk of lung cancer in heavy smokers to give them beta carotene supplements. The results showed supplements actually increase the risk of cancer in smokers.
Drinking alcohol in moderation, if at all do not. Limit yourself to one drink a day if you're a woman or two drinks a day if you're a man. Any person age 65 or older should drink no more than one drink a day.
Sports. Achieve at least 30 minutes of sports on every day of the week. Check with your doctor first if you have not exercised regularly. Start slowly and keep adding more activities. Cycling, swimming and walking are good choices. Add to exercise throughout your day - through the park when she went to work and walk along the road or take the stairs instead of elevators.

Lung Cancer Treatment

Tags : Lung Cancer, Lung Cancer Prevention, Prevention Of Lung cancer, Prevention Of cancer

Lung Cancer Treatment

Bronchial benign tumors are usually removed surgically because they can clog the bronchi and long may become malignant.
Sometimes performed surgery on the cancer other than small cell carcinoma that has not spread. Approximately 10-35% of cancers can be removed surgically, but surgery does not always bring healing.

Approximately 25-40% of patients and isolated tumor grows slowly, has a life expectancy of up to 5 years after his illness was diagnosed. Patients should perform routine checks for lung cancer recurrence in 6-12% of patients who had undergone surgery.

Before surgery, performed lung function tests to determine whether the remaining lung can still perform its functions well or not. If the result is ugly, it is not possible to do surgery.
Surgery is not necessary if:
- The cancer has spread beyond the lung
- Cancer is too close to the trachea
- Patients have serus circumstances (such as heart disease or lung disease is severe).

Radiation therapy performed in patients who can not undergo surgery because they have other serious illnesses.
The purpose of radiation is to slow cancer growth, not for healing. Radiation therapy also can reduce muscle pain, superior vena cava syndrome and suppression of the spinal cord. But radiation therapy can cause inflammation of the lungs (pneumonitis due to radiation), with symptoms such as cough, shortness of breath and fever. These symptoms can be reduced by corticosteroids (eg prednisone).

At the time of diagnosis, small cell carcinoma almost always has spread to other body parts, making it impossible to do surgery. These cancers are treated with chemotherapy, sometimes radiation therapy disetai.

Patients with lung cancer who experienced a lot of lung function decline. To reduce respiratory problems may be given oxygen therapy and drugs that dilate the airways (bronchodilators).

Lung Cancer Prevention

Tags : Lung Cancer, Lung Cancer Treatment, Treatment of lung cancer, treatment for cancer, treatment of cancer, chemotherapy treatment, cancer radiation treatment, radiation treatment, lung cancer chemotherapy, lung cancer survival

Lung Cancer

Most lung cancers originate from cells in the lungs, but lung cancer can also originate from cancer in other body parts that spread to the lungs.

Lung cancer is the most common cancer in both men and women.
Lung cancer is also the leading cause of cancer deaths.
Lung cancer definition, Lung cancer prognosis, symptoms lung cancer, cancer symptoms, symptoms of cancer, small cell cancer, lung cancer smoking, lung cancer treatment, lung cancer survival, lung cancer pain
Types of Lung Cancer

More than 90% of lung cancers originated from the bronchi (large airways into the lungs), cancer is called carcinoma bronchogenic, which consists of:
Squamous cell carcinoma
Small cell carcinoma or squamous cell wheat
Large cell carcinoma


Alveolar cell carcinoma derived from air pockets (alveoli) in the lungs. This cancer can be a single growth, but often strike more than one area in the lung.

Lung tumors are less common are:
Adenoma (can be malignant or benign)
Condromatous hamartoma (benign)
Sarcoma (malignant)

Lymphoma is a cancer of the lymph system, which can be derived from the lung or is spread from another organ.
Many cancers that originate from other places to spread to the lungs. This cancer usually comes from the breast, colon, prostate, kidney, thyroid, stomach, cervix, rectum, testicles, bones and skin.

Causes of Lung Cancer
Smoking is a major cause of about 90% of cases of lung cancer in men and about 70% in women.
The more cigarettes smoked, the greater the risk for lung cancer.

Only a small proportion of lung cancer (about 10% -15% in men and 5% in women) caused by or inhaled substances encountered at work.
Working with asbestos, radiation, arsenic, chromate, nickel, chloromethyl ethers, mustard gas and coke oven emissions can cause lung cancer, although usually only occurs in workers who also smoked.

Role air pollution as a cause of lung cancer is still unclear.
Some cases occur because of exposure by radon gas in the household.

Sometimes, lung cancer (particularly adenocarcinoma and alveolar cell carcinoma) occurred in people who already have lung scarring due to other lung diseases, such as tuberculosis and fibrosis.

Large Cell Carcinoma, Small Cell Carcinoma

Smoking is a major cause of about 90% of cases of lung cancer in men and about 70% of cases in women. The more cigarettes smoked, the greater the risk for lung cancer.

Only a small proportion of lung cancer (about 10% -15% in men and 5% in women) caused by or inhaled substances encountered at work. Working with asbestos, radiation, arsenic, chromate, nickel, chloromethyl ethers, mustard gas and coke oven emissions can cause lung cancer, although usually only occurs in workers who also smoked.

The role of air pollution as a cause of lung cancer is still unclear.
Some cases occur because of exposure by radon gas in the household.

Sometimes, lung cancer (particularly adenocarcinoma and alveolar cell carcinoma) occurred in people who already have lung scarring caused by other lung diseases, such as tuberculosis and fibrosis.

Lung Cancer Symptoms
Symptoms of lung cancer depends on the type, location and how its spread.

Usually the main symptom is a persistent cough.
Chronic bronchitis patients who suffer from lung cancer is often noticed that her cough is getting worse.

Sputum may contain blood.
If the cancer grows into the underlying blood vessels, can cause severe bleeding.

Cancer can cause wheezing sound due to the narrowing of the airways in or around the growth of cancer.
Bronchial obstruction may lead to the collapse of the lungs which is a ramification of bronchus, the condition is called atelectasis
Another result is pneumonia with symptoms such as cough, fever, chest and shortness of pain breath.

If the tumor grows into the chest wall, can cause persistent chest pain.

Symptoms that occur later are loss of appetite, weight loss and weakness.
Lung cancer often leads to accumulation of fluid around the lungs (pleural effusion), so that patients experiencing shortness of breath.
If the cancer spreads in the lungs, may develop severe shortness of breath, low blood oxygen levels and heart failure.

Cancer can grow into certain nerves in the neck, causing the occurrence of Horner syndrome, which consists of:
- Eyelid closure
- Small pupils
- Sunken eyes
- Reduced perspiration on one side of the face.

Cancer in the top of the lungs can grow into the nerves to the arm so that the arm pain, numbness and weakness. Damage can also occur in the nerve cords so that people with a hoarse voice.

Cancer can grow directly into the esophagus, or growing near the throat and squeezed, resulting in impaired swallowing. Sometimes abnormal tract formed (fistula) between the esophagus and bronchi, causing severe coughing during swallowing process takes place, because food and liquid into the lungs.

Lung cancer may grow into the heart and causes:
- Abnormal heart rhythm
- Enlarged heart
- Accumulation of fluid in the pericardial sack.
Cancer also can grow around the superior vena cava. This causes blockage of venous blood flowing back upwards, ie into other veins of the upper body:
- Vein in the chest wall will be enlarged
- Face, neck and upper chest wall (including breast) will swell up and appear purple.
This situation also causes shortness of breath, headache, visual disturbances, dizziness and drowsiness. The symptoms are usually worse if the patient bend forward or lie down.

Lung cancer can also spread through the bloodstream to the liver, brain, adrenal glands and bone. This can happen at an early stage, especially in small cell carcinoma.
Symptoms of liver failure, confusion, seizures and bone pain; that could arise before the occurrence of various disorders of the lungs, making early diagnosis difficult to enforce.

Some lung cancer cause effects at a distance from the lungs, such as metabolic disorders, nerve disorders and muscle disorders (paraneoplastic syndrome).
This syndrome is not related to the size and location of the cancer and does not necessarily indicate that the cancer has spread beyond the chest; syndrome is caused by material released by cancer.
The symptoms can be an early marker of cancer or an early indication that the cancer had returned, after such treatment.
One example of the paraneoplastic syndrome is the Eaton-Lambert syndrome, characterized by muscle weakness incredible. Another example is muscle weakness and pain due to inflammation (polymyositis), which may be accompanied by inflammation of the skin (dermatomyositis).

Some lung cancer or hormone releasing hormone-like material, resulting in high levels of hormones that.
Small cell carcinoma producing corticotropin (causing Cushing's syndrome) or antidiuretic hormone (causing fluid retention and low sodium levels in the blood).
Formation of excessive hormone can also cause carcinoid syndrome, namely in the form of redness, wheezing breath sounds, diarrhea and heart valve abnormalities.
Squamous cell carcinoma releasing hormone-like material that causes very high blood calcium levels.

Other hormonal syndromes associated with lung cancer are:
- Breast enlargement in men (gynecomastia)
- Excess thyroid hormone (hyperthyroidism)
- Changes in the skin (the skin in the armpit become darker).
Lung cancer can also cause changes in the form of fingers and finger jkaki and changes at the end of long bones, which can be seen on x-rays.

Lung Cancer Diagnosis
If someone (especially smokers) have a cough that persists or worsens or symptoms of other lung, then there is the possibility of lung cancer.
Sometimes the first hint of a shadow found on chest x-ray of someone who showed no symptoms. Chest X-rays can find most of lung tumors, although not all the shadows that look is a cancer.

Usually performed microscopic examination of tissue samples, which are sometimes derived from patients with sputum (sputum cytology). To obtain the necessary network, performed bronchoscopy.

CT scans can show a small shadow that is not visible on chest x-rays and may reveal enlarged lymph nodes.
To find the spread to the liver, adrenal gland or brain, a CT scan of the abdomen and brain.

Spread to the bone can be seen through skening bone. Bone marrow biopsy is sometimes done, because of small cell carcinoma tends to spread to the bone marrow

Classification (stage) of cancer based on:
- Tumor size
- Spread to lymph nodes nearby
- Spread to other organs.
This stage is used to determine the type of treatment will be performed and the prediction of disease in patients.

Lung Cancer Treatment

Lung Cancer Prevention

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Pleurisy is irritation and inflammation in the pleura.

Pathophysiology and Etiology
  1. Secondary occur as a result of the primary causes such as pneumonia (bacterial or viral), pulmonary embolism, pulmonary tuberculosis, bronchiectasis.
  2. Associated with rib fractures and thoracic wall.
  3. Irritation that comes from below the diaphragm: hepatitis or abscess subfrenik.
  4. Pleurodinia epidemic (Bornholm disease, devil's grippe).
  5. Pleurodinia epidemics such as "lupus erythematosus"
  6. Inflammation of the pleura with fibrineus exudate can lead to pleural adhesions.

Pleurisy Symtomps
  • Complaints and symptoms according to the basic disease, such as pneumonia, pulmonary infarction, but the protruding chest pain.
  • Chest pain like being stabbed associated with inspiration and expiration.
  • Breathing becomes shallow and rapid.
  • Because of pain, reduced chest expansion on the sore area and decreased breath sounds.
  • Pleural friction sound can be heard on breathing in, especially on the "dry pleurisy".
  • Dry cough is ineffective and accompanied by pain.
  • Febrile and malaise.

Physical examination
  • Chest wall can mencembung due to pleural effusion. If you already have pencembungan chest pain usually lessens. Percussion sounds overcast condition on the sore area and decreased breath sounds on auscultation until it disappears.
  • "Pleural friction rub" that is, pleural friction sound may be heard through a stethoscope during respiration.
  • Where the string sound in sync with the systolic and strengthened in time breathing the possibility of friction noise coming from the pleuro-pericardial.

Chest X-Ray  Photo.
  • Chest X-Ray image is important to look for basic illnesses such as lung tumors, pulmonary tuberculosis, pneumonia and effusion.
  • Normal chest X-Ray photos, and chest pain possible "dry pleurisy".
  • But the normal chest image, can not rule out the possibility of lung disease as the cause pleurisy.
Pleural puncture to aid the diagnosis by microscopic examination and culturing.

  • Pleurisy diagnosis can be enforced, if the patient complained of pleuritic pain or a pleural friction sound.
  • Typical signs of pleural pain is pain like being stabbed with a knife (sharp pain) and increased pain when the patient breathe deeply or cough.

Differential Diagnosis
  • Herpes zooster
  • Fracture rib
  • Non-rheumatic disorders such as fibrositis artikuler
  • Pericarditis
  • Pneumothorax.

Management of pleurisy
  • Analgesics such as antalgin can be given according to need. In severe pleuritic pain may be given pethidine 100 mg im or morphine 10 mg i.m.
  • Antibiotics or chemo-terapeutic for basic illnesses.
  • The rib fractures, chest bandage.
  • See also pleural effusion.

  • Depending on the basic disease and is usually cured by treating the basic disease.
  • Can be a "Chronic Adhesive Pleurisy" that interfere with lung physiology.

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