Diffuse alveolar hemorrhage or pulmonaryrenal syndrome Administer IV steroids

4. Nonsurgical patient with localized bleeding. Perform bronchial arteriography followed by embolization.

E. Surgery. Consider when embolization has failed or is not feasible.

VI. Problem Case Diagnosis. Physical exam of the 10-year-old boy was unremarkable except for a soft murmur over the left chest. ECG

was normal, but a chest CT scan revealed a pulmonary AVM that was confirmed and further defined by selective arteriogram. Patient underwent an uncomplicated resection of the AVM.

VII. Teaching Pearl: Question. What does the presence of pallor suggest when seen in conjunction with hemoptysis?

VIII. Teaching Pearl: Answer. Pallor in conjunction with hemoptysis indicates that massive bleeding has occurred.

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