Ch. 10 Thoracic & Respiratory Flashcards
In which 3 conditions will administering supplemental O2 not improve cyanosis?
- hemoglobinopathies
- cyanide poisoning
- anatomic shunt
How is MASSIVE hemoptysis defined?
coughing up >100-600mL of blood in 24 hours period
What are the 3 most common causes of hemoptysis?
bronchitis, bronchogenic carcinoma, bronchiectasis
(although 30% have no identifiable cause)
Hemoptysis and renal insufficiency may be suggestive of which two syndromes?
Wegener granulomatosis or
Goodpasture Syndrome
Massive hemoptysis almost always originates from the high-pressure ______ arteries.
bronchial
In a patient with massive hemoptysis, what is a good way to position the patient?
bleeding side does to theoretically maximize V/Q ratio
What are two management options for massive hemoptysis?
- urgent bronchoscopy – can balloon tamponade, topical medications
- Angiography of bronchial arteries +/- embolization
What are the 3 most common causes of pleural effusions?
CHF, pneumonia, and cancer
What are the two ways to classify pleural effusions
transudative or exudative
What are the 3 most common causes of TRANSUDATIVE pleural effusions?
CHF, cirrhosis, and nephrotic syndrome
List some common causes of EXUDATIVE pleural effusions.
malignancy, bacterial, and viral pneumonia, TB,
PE, pancreatitis, esophageal rupture, collagen vascular disease, chylothorax,
and hemothorax.
What do you call pleural effusions associated with pneumonia?
parapneumonic effusions
- can lead to formation of empyema with loculations and pleural thickening
What is lights criteria?
Distinguished Transudative from Exudative pleural effusions;
Pleural fluid/serum protein ratio >0.5
Pleaural fluid LDH >2/3 upper limit of serum reference range
Pleural fluid/serum LDH ratio >0.6
If one of the above is present –> EXUDATIVE
if none –> transudative
What triglyceride level in pleural fluid would indicate a chylothorax?
triglycerides >110 mg/dL
