cardiothoracic Flashcards

1
Q

what is a pleural effusion?

A

the accumulation of fluid in the pleural space that can be transudate or exudate

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2
Q

what are symptoms of a pleural effusion?

A
  • dyspnoea
  • pleuritic chest pain
  • cough
  • fever
  • chills
  • weight loss
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3
Q

what is transudate?

A

low protein content due to cahnges in oncotic and hydrostatic forves

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4
Q

what are causes of transudate pleural effusion?

A
congestive heart failure
ascites
cirrhosis
hypoalbuminaemia
nephrotic syndrome
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5
Q

what is exudate?

A

high in protein and contains more lactate dehydrogenase

due to inflammatory/ infection neoplastic syndromes

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6
Q

what is the medical management options for a pleural effusion?

A
  • diuretics
  • physio
  • antibiotics
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7
Q

what diuretics are good for pleural effusion?

A
  • often durosemide is used

- if they have refractory volume overload non loop diuretics can be helpful

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8
Q

what antibiotics are good for pleural effusion?

A
  • amoxicillin
  • clindamycin
  • not aminoglycosides
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9
Q

what are surgical options for pleural effusion?

A
  • therapeutic thoracocentesis
  • tube thoracostomy
  • drainage catheter placement
  • pleurodesis
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10
Q

what is therapeutic thoracocentesis?

A

A needle catheter is used going above the rib in the lateral chest wall

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11
Q

when is thoracocentesis used for pleural effusion?

A
  • larger than 1cm
  • causing symptoms
  • doesn’t meet the criteria for chest drainage
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12
Q

what are possible complications of thoracocentesis?

A
  • pneumothorax
  • haemothorax
  • laceration
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13
Q

what is pleurodesis?

A

obliteration of the pleural space to prevent recurrent pleural effusions

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14
Q

what agents are typically used for pleurodesis?

A
  • talc

- silver nitrate

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15
Q

what are medical options for a pneumothorax?

A
  • high flow oxygen

- chemical pleurodesis

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16
Q

when is high flow oxygen used for pneumothorax?

A
  • patients with a secondary pneumothorax that is under 1cm and observed for 24 hours
17
Q

what are surgical options for pneumothorax?

A
  • intercostal drain
  • aspiration
  • chest drain
18
Q

what is the first line treatment surgically for all pneumothoraxs needing intervation?

A

aspiration

19
Q

when is chest drain suction used for a pneumothorax?

A
  • tension

- over 2cm making them breathless