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Pulmonology > Class Notes > Flashcards

Class Notes Flashcards

1
Q

Stenocardial and pleuritic is found

A

Pulmonary embolism

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2
Q

How does pleuritic chest pain feel

A

Sharp stabbing chest pain

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3
Q

What does dull chest pain indicate

A

Stenocardial

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4
Q

Side effect of an SSRI

A

Pulmonary hypertension

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5
Q

Types of pneumothorax

A

Tension
Iatrogenic
Spontaneous

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6
Q

Types of spontaneous pneumothorax

A

Primary and secondary

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7
Q

What is the difference between primary spontaneous pneumothorax and secondary

A

Primary is without lung disease present aspiration is enough, while in secondary lung disease is present such as COPD and cystic fibrosis

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8
Q

What can happen in tension pneumothorax

A

Due to shot wound, air will move to the plural space and increase pressure and mediastinum will shift to the opposite side and can obstruct great vessels

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9
Q

Which type of pneumothorax is considered a medical emergency

A

Tension pneumothorax

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10
Q

Treatment of tension pneumothorax

A

Place a catheter or a drainage in to the 2nd intercostal space

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11
Q

What is considered a big pneumothorax

A

Later of air bigger than 2CM

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12
Q

What is done in a big pneumothorax

A

Drainage

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13
Q

What is considered a small pneumothorax

A

Smaller than 2CM can happen if a catheter is placed in the the plural space

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14
Q

What is done in case of small pneumothorax

A

If there are no symptoms just give O2 and wait (conservative treatment)

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15
Q

What is done in secondary pneumothorax

A

Chest drainage is needed

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16
Q

Where to place chest drainage

A

Safe triangle

17
Q

Where to place aspiration

A

2nd intercostal space

18
Q

How do we insert anything through the chest

A

We go over the rib and we use local anaesthesia since below the rib there’s artery vein nerve

19
Q

When is X-ray preformed for pneumothorax

A

On diagnosis, after 6 hours and after 24 hours

20
Q

What is the conservative treatment for pneumothorax

A

Wait observe and give O2

21
Q

What is pleurodesis

A

Injecting tetracycline, iodine, belomycin, talk or tissue glues which causes inflammation and cause the pleura to stick

22
Q

Indications of pleurodesis

A
  • Primary spontaneous pneumothorax drained for more than 5-7 days
  • Secondary spontaneous pneumothorax
  • to prevent recurrent pneumothorax and plural effusions
23
Q

Main complications of pleurodesis

A

Painful - give lidocaine intrapleurally, painkillers or opioids

24
Q

What is a plural effusion

A

Fluid in the pleural cavity which can be transudate or exudate based on (lights criteria)

25
Q

What can cause a transudate pleural effusion

A

Heart failure
Liver failure
Nephrotic syndrome….
Less than 0.5 protein and 0.6 LDH

26
Q

What is lights criteria

A

If the fluid has
protein ratio over >0.5
LDH serum LDH>0.6
Pleural fluid LDH>2/3 ofULN serum LDH
Then it is an exudate and further tests are required
If not then it is a transudate and no further tests are required

27
Q

What can cause exudate pleural effusion

A 
Infection 
Neoplasm 
Immunological disease
Pneumonia 
TB
More than 0.5 protein and 0.6 LDH
28
Q

When is it more common to be needed to evacuate the fluid

A

If it’s an exudate since symptoms start showing up

29
Q

What is done in case of malignancy and pleural exudate

A

Pleurodesis because it will probably relapse

30
Q

What is done after identifying a pleural exudate

A

We need to find the underlying disease and treat it

31
Q

What indicates an immediate chest drainage

A

Pleural fluid of PH lower than 7.2

32
Q

What can effusions rich in lymphocytes be caused by

A

Malignancy, TH, lymphoma, heart failure, rheumatoid arthritis or chylothorax

33
Q

What could effusion rich in eosinophils be caused by

A

Pneumothorax

34
Q

What is chylothorax

A

(Rare cause of pleural effusion) yellow millet liquid, rich in triglycerides more than 1.24 mmol/L

35
Q

What is empyma

A

Infected fluid in pleural cavity and is and indication for chest drainage and in some cases is treated surgically

36
Q

How does empyma look

A

Thick yellow green pus

37
Q

What is hemothorax

A

The hematocrit is over 50% of peripheral blood

It could be misleading in cases of empeyema and malignancy causes effusion so we need to find hematocrit percentage

38
Q

What should be done in the case of a hemothorax and why

A

We need to drain it (CHEST DRAINAGE)

High risk of empyma development and can lead to fibrothorax

Pulmonology (2 decks)

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