CABS: Pleural Diseases

Question 1

What is the barometric pressure

Answer 1

760 mmHg (0 mmHg)

Question 2

What is the alveolar pressure

Answer 2

760 mmHg (0 mmHg)

Question 3

What is the intrapleural pressure

Answer 3

750 mmHg (-4 - -10 mmHg)
always negative

Question 4

Pleural effusion is

Answer 4

a accumulation of fluid in the space between the visceral and parietal pleura

Question 5

Normal amount of fluid in between the pleura

Answer 5

10cc

Question 6

Pleural fluid helps assist with

Answer 6

lubrication, infection prevention, maintain negative pressure

Question 7

Effusions form when fluid cannot _____ or is ______

Answer 7

drain or is created in excess

Question 8

Pleural effusions are m/c associated with

Answer 8

CHF, pneumonia and cancer

Question 9

Transudative Pleural effusion

Answer 9

too much fluid
normal plasma filtrate just too much of it
low LDH, proteins
occurs due to increased hydrostatic pressure or low plasma oncotic pressure

Question 10

Exudative Pleural effusion

Answer 10

Bad - pus filled fluid, contains more WBW, plasma proteins
elevated LDL, protein
occurs due inflammation and increased capillary permeability

Question 11

Hemothorax is a

Answer 11

effusion but with blood
traumatic, rupture

Question 12

Chylothorax is a

Answer 12

milky fluid with fat droplets and lymph fluid

Question 13

Empyema is

Answer 13

pus
accumulation of infection

Question 14

Pleural effusion presentation

Answer 14

small ones can be asymptomatic
sxs will increase based on size and pts underlying hemodynamics: SOB, Pleuritic pain, dullness to percussion, pleural friction rub

Question 15

Pneumothorax is

Answer 15

air within the pleural space secondary to rupture of the visceral pleura or parietal pleura

Question 16

Pneumothorax m/c caused by

Answer 16

spontaneous (primary), iatrogenic (secondary), traumatic (secondary)

Question 17

In a pneumo a break in pleura will cause

Answer 17

pressure to equilibrate, will disrupt the negative pressure within the pleural space and cause lung to recoil

Question 18

Idiopathic example in a pneumo

Answer 18

marfans (pts tall/thin)

Question 19

Iatrogenic example in a pneumo

Answer 19

mechanical vent
line placement
lung bx

Question 20

traumatic example in a pneumo

Answer 20

penetrating chest wound
rib fracture that punctures lung parenchyma

Question 21

Open pneumo is

Answer 21

damaged chest wall allows air in during inspiration

Question 22

Treatment for open pneumo

Answer 22

three-way dressing (three sides taped down, one side open)
chest tube
surgical repair

Question 23

tension pneumo is

Answer 23

air in the pleural space increasing and unable to escape, can compress on the structures (mediastinal shift)

Question 24

Pneumomediastinum is

Answer 24

free air around the mediastinal structures

Question 25

Pleurisy (aka pleuritis) is

Answer 25

inflammation of the pleura

Question 26

Presentation of pleuritis

Answer 26

pleuritic pain
sharp or stabbing pain with inspiration or cough
may feel SOB secondary to the discomfort
pleural friction rub

Question 27

ARDS will always be

Answer 27

bilateral

Question 28

How do you image a pneumo

Answer 28

Xray - upright

Question 29

Treatment of a small pneumo

Answer 29

O2
observation