2.9 Interstitial and Pleural Disease

Question 1

What are the two respiratory centers responsible for signaling that leads to dyspnea?

Answer 1

Chemoreceptors: Stimulated by hypoxemia, acidosis, and hypercapnia
Mechanoreceptors: Monitor changes in pressure, flow, and volume in the respiratory system

Question 2

What are the typical etiologies for chronic dyspnea?

Answer 2

Asthma, COPD, interstitial lung disease, myocardial dysfunction, pleural effusion

Question 3

What three causes within the cardiovascular system may lead to acute dyspnea?

Answer 3

Acute myocardial ischemia, congestive heart failure, and cardiac tamponade

Question 4

What are the symptoms of interstitial lung disease?

Answer 4

Progressive dyspnea, nonproductive cough, fatigue, wheezing, and hemoptysis

Question 5

In restrictive lung disease, the lungs are less _______ and have _______ diffusion because of thickened alveolar walls.

Answer 5

Compliant; reduced

Question 6

What are the most common presentations in sarcoidosis?

Answer 6

Abnormal CXR, respiratory symptoms, skin lesions, and ocular symptoms

Question 7

A pleural effusion can be diagnosed by what results on examination?

Answer 7

Decreased or absent tactile fremitus, dullness to percussion, and diminished breath sounds over the area of the effusion

Question 8

What are the criteria needed to diagnose an exudative pleural effusion?

Answer 8

1. Pleural fluid protein divided by the serum protein is greater than 0.5
2. Pleural fluid LDH divided by the serum LDH is greater than 0.6
3. Pleural fluid LDH is greater than two-thirds of the upper limit of normal for the serum LDH

Question 9

Hyper-resonence on percussion along with diminished tactile fremitus and mediastinal shift are indicative of?

Answer 9

Pneumothorax

Question 10

What disease should be considered in anyone with an exudative pleural effusion?

Answer 10

Neoplastic Disease, will also have bloody pleural fluid