105 - Pleurisy Flashcards

1
Q

What is pleurisy?

A

Inflammation of the pleura - due to pneumonia or lung disease

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2
Q

What management options are there for a pneumothorax?

A
Allow spontaneous resorption
Needle Aspiration
Chest drain
Surgery - talc pleurodesis, pleurectomy
Endobronchial valve
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3
Q

What are the 2 types of tension pneumothorax?

A

+ve pressure ventilation - air can’t escape from the pleura, but more air is forced in on inspiration - gets bigger
Flap valve, air is brought in through trauma wound but the flaps shut on expiration trapping air

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4
Q

What is the management of a tension pneumothorax?

A

Immediate - 100% high flow 02

Needle thoracocentesis - 2nd ICS, mid clavicular line, hear hiss, then drain

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5
Q

What is the key sign on a Xray of a pleural effusion?

A

Blunting of the costaphrenic angle

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6
Q

What investigations would you do for a pleural effusion?

A

Chest X ray
Ultrasound
Aspiration

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7
Q

What are the 2 classes of fluid that come out of an aspiration of a pleural effusion

A

Transudate - Less than 30 protien - due to organ failures

Exudate - More than 30 protein. Acidic - Ph <7.2. Cloudy. Due to cancer, TB, inflammation, trauma, PE..

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8
Q

Where is turbulent air flow?

A

Trachea

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9
Q

Where is transitional air flow?

A

Bronchial tree

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10
Q

Where is laminar air flow?

A

In the broncioles

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11
Q

How do you measure dead space in the resp system?

A

Bohr equation

or Fowlers method (estimate anatomical dead space)

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12
Q

How is pulmonary vascular resistance changed?

A

Passively - recruitment of collapsed vessels, distension of existing vessels.

Actively - HPV - Hypoxic pulmonary vasocontriction - alveolar hypoxia contricts the small pulmonary arteries, which is used a birth and to direct blood away from diseased lung
- Pulmonary vascular resistance - normally very small, decreases on exercise, increases in hypoxia, increases in high + low lung volumes

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13
Q

Where is there the most resistance in the airways?

A

Half in nasopharynx

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14
Q

Where is there the most resistance in the lungs?

A

90% in the central airways - bronchi

10% in peripheral airways

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15
Q

What causes the biggest effect on FEV1:FVC when it narrows?

A

Median sized airways - bronchi

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16
Q

what is the normal FEV:FVC ratio (spirometry)

A

0.75 - 0.8

17
Q

How long after breathing out as far as possible is FEV (forced expiratory volume) measured?

A

1 second

18
Q

How is FVC measured? Forced vital capacity

A

The lowest point reached when breathing out as far as possible.

19
Q

What occurs to the FEV:FVC ration in an obstructive abnormality?

A

It falls below 0.75

20
Q

What occurs to the FEV:FVC in a restrictive condition?

A

It is normal or higher than normal (as can’t breath out as much due to pain of restriction)

21
Q

What are the metabolic functions of the lung?

A

Renin-angiotensin system - Angiotensin 1 is converted to angiotensin II in the lung
Inactivation of some amines and purines
Activation of arachidonic acid