Chest Wall Disorders

Question 1

what is a lung abscess

Answer 1

localised collection of pus within the lung tissue

Question 2

how do lung abscesses arise

Answer 2

aspiration, TB, pneumonia, septic emboli

Question 3

what are the symptoms of lung abscess

Answer 3

pneumonia, foul sputum, raised inflammatory markers, cavity formation on CXR

Question 4

what is the treatment for lung abscess

Answer 4

surgical drainage if severe

antibiotics based on culture results

Question 5

describe a pleural effusion

Answer 5

excessive fluid within pleural space
transudate <30g/l of protein
exudate >30g/l of protein

Question 6

symptoms of pleural effusion

Answer 6

breathlessness sometimes with chest pain

Question 7

how will a pleural effusion appear on a CXR

Answer 7

obliterated costophrenic angle and raised hemi-diaphragm

pleural effusion detectable when >300ml on x-ray

Question 8

what is the treatment of pleural effusion

Answer 8

treat underlying cause

drain fluid through thoracocentesis (5th intercostal space mid-clavicular line)

Question 9

what is cor pulmonale

Answer 9

heart failure due to pulmonary hypertension - causes hypoxia - vasoconstriction - increases pressure on right side of heart

Question 10

what is pulmonary hypertension classified as

Answer 10

pulmonary artery pressure of >25mmHg

Question 11

when does cor pulmonale arise

Answer 11

advanced COPD

emphysema

Question 12

what are the symptoms of cor pulmonale

Answer 12

breathlessness, ankle oedema, RV hypertrophy, elevated JVP, parasternal heave and tricuspid regurgitation

Question 13

what is the treatment for cor pulmonale

Answer 13

exercise moderately
oral anticoagulants eg rivaroxaban, epixaban
diuretics
O2 if required