JAAPA CME Post-Test October 2025

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Evaluation and Management of Hemoptysis

Hemoptysis, defined as the expectoration of blood originating from the lower respiratory tract, is a clinical symptom with a wide differential diagnosis that ranges from benign to life-threatening causes. Common causes vary by geographic region and care setting, with respiratory infections, malignancy, bronchiectasis, and chronic obstructive pulmonary disease being predominant in resource-rich countries and tuberculosis remaining the leading cause in resource-limited areas. Though most cases are mild and self-limited, hemoptysis can be a life-threatening medical emergency; these cases are associated with a mortality exceeding 50%, primarily due to asphyxia. Management strategies are informed by severity, with outpatient care appropriate for stable patients with non-life-threatening hemoptysis and intensive interventions—such as bronchial artery embolization or surgical resection—reserved for those with high-risk features or life-threatening hemoptysis. This activity provides an evidence-based approach to hemoptysis evaluation and management, emphasizing the importance of early risk stratification, identification of underlying causes, and timely intervention. By integrating a structured diagnostic and therapeutic approach, clinicians can improve outcomes and reduce the risk of recurrence and complications.

Learning Objectives

At the conclusion of this activity, participants should be able to:
  • Differentiate between non-life-threatening and life-threatening hemoptysis based on clinical presentation and diagnostic thresholds
  • Interpret key findings from history, physical examination, and imaging to identify the probable cause and source of hemoptysis
  • Formulate an evidence-based management plan tailored to the severity of bleeding and underlying cause, incorporating appropriate diagnostic and therapeutic interventions

Pelvic Floor Physical Therapy: Enhancing Patient Outcomes

Pelvic floor disorders are a wide-ranging group of conditions arising due to abnormalities of the musculature of the pelvic floor. These conditions can include constipation, pelvic pain, urinary incontinence, and dyspareunia. This article first provides an overview of key anatomy of the pelvic floor muscles before discussing pelvic floor physical therapy (PFPT), highlighting the goals of treatment and tactics used by physical therapists to achieve these goals. The article then explores the definition, diagnosis, and treatment of constipation, pelvic pain, and urinary incontinence caused by pelvic floor dysfunction. It is meant to help reduce the gap in this underdiagnosed and undertreated condition and identify key patient populations that may significantly benefit, including through improvements to quality of life, from PFPT.
 

Learning Objectives

At the conclusion of this activity, participants should be able to:
  • Describe the anatomy and function of the pelvic floor and its role in continence and pelvic organ support
  • Identify the clinical features of chronic pelvic pain, SUI, and DD
  • Recognize patients who are candidates for PFPT and describe appropriate referral pathways
  • Explain the mechanisms and modalities used in PFPT, including manual therapy, biofeedback, and neuromuscular training
  • Evaluate the clinical evidence supporting PFPT as an effective intervention for improving patient outcomes and quality of life across pelvic floor disorders
 

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