Chest Wall, Pleural and Pulmonary Disorders Flashcards

1
Q

What is a pneumothorax?

A

Air in the pleural space

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2
Q

Who is more likely to get a spontaneous pneumothorax?

A

Tall, thin males

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3
Q

How is pneumothorax treated?

A

Needle aspirate 2nd ICS, mid-clavicular line

Chest drain 5th ICS mid-axillary line with large cannula if unresolved

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4
Q

What is an exudate in the pleural space of pH less than 7.2 highly suggestive of?

A

Empyema

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5
Q

What is pleural effusion?

A

Fluid in the pleural space

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6
Q

What are the features of a transudate?

A

Protein less than 30g/l

LDH less than 200

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7
Q

Which conditions cause transudate?

A

Heart failure
Nephrotic syndrome
Pericarditis

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8
Q

What are the features of an exudate?

A

Protein more than 30g/l

LDH more than 200

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9
Q

Which conditions cause exudate?

A
TB
Pneumonia
Cancer
MI
Pancreatitis
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10
Q

How much fluid is required in pleural effusion to be detected on a CXR?

A

More than 300ml

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11
Q

What is cor pulmonale? How does it arise?

A

Right heart failure due to pulmonary hypertension
Alveolar damage causes reduced gas exchange (hypoxia), causing pulmonary vasoconstriction which builds up pressure in the right heart

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12
Q

List some symptoms and signs of pulmonary hypertension

A
Ankle oedema
Progressive breathlessness
Elevated JVP
Ascites
Parasternal heave/tricuspid regurgitation
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13
Q

How do pulmonary embolisms most commonly arise?

A

Thrombus from legs gets stuck in pulmonary arteries

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14
Q

What are the 3 components of Virchow’s Triad?

A

Damage to endothelium
Abnormal blood flow
Hypercoagulable blood

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15
Q

What are some symptoms of PE?

A

Sudden breathlessness
Sudden pleuritic pain
Tachypnoea
Fever

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16
Q

If D-dimer is undetected in investigations, rule out PE diagnosis completely. True/False?

A

True

17
Q

Apart from D-dimer, what are useful investigations to do for PE?

A

V/Q scan (show underperfused areas)

CTPA is gold standard for diagnosis