Diseases of the Pleura

Question 1

What can cause tension pneumothorax?

Answer 1

Stab wound, MVA, rib fracture

Question 2

Tension pneumothorax results in compression atelectasis with a mediastinal shift away from the affected lung (TRUE/FALSE)?

Answer 2

FALSE (no shift)

Question 3

What is an emphysematous bleb?

Answer 3

A blister or air pocket on the lung that pops that may cause lung collapse

Question 4

What is tension pneumothorax?

Answer 4

Leakage of air in the pleural cavity between the visceral and parietal pleura

Question 5

What is pneumothorax?

Answer 5

Air in the pleural cavity

Question 6

What is the cause of traumatic pneumothorax?

Answer 6

Perforating chest wound (stab or rib fracture/MVA), therapeutic aspiration of fluid, lung biopsies

Question 7

What type of atelectasis does pneumothorax cause? Is there a mediastinal shift?

Answer 7

Compression, no shift

Question 8

Patient presents to the ER after a motor vehicle accident with severe dyspnea and pain on the right side of his chest. What type of pneumothorax is this describing?

Answer 8

Traumatic pneumothorax

Question 9

What can cause spontaneous pneumothorax?

Answer 9

Emphysema, asthma, tuberculosis, abscess, emphysematous blebs

Question 10

18 year old male patient reports to his lab instructor that he thinks his lung has collapsed. He states he has had this happen to him before due to a lung blister. What type of pneumothorax is this?

Answer 10

Spontaneous pneumothorax

Question 11

Absence of breath sounds on the affected side is indicative of what?

Answer 11

Atelectasis of a lung

Question 12

What will a chest radiograph show in a patient with pneumothorax?

Answer 12

Collapse of the lung on the side of pain and a large collection of air in the pleural space

Question 13

What condition can cause a serofibrinous pleural effusion in the lungs?

Answer 13

Inflammation in adjacent lung

Question 14

Patient presents with right sided chest pain. Auscultation reveals a pleural friction rub that sounds scratchy. What is the likely diagnosis. What may have caused it?

Answer 14

Serofibrinous exudate pleural effusion caused by inflammation in an adjacent lung

Question 15

What is empyema?

Answer 15

Pus in the pleural space

Question 16

A suppurative inflammation will have what characteristics?

Answer 16

High protein, high cell, high specific gravity

Question 17

A serofibrinous exudate will have what unique characteristic?

Answer 17

Clotting factors and pleural friction rub

Question 18

Patient presents with right sided chest pain. He has been fighting bronchopneumonia for two weeks now. Aspiration of the pleural cavity on the right side reveals a fluid with high specific gravity, high protein, and high cells. What is the likely diagnosis?

Answer 18

Suppurative (empyema) pleural effusion

Question 19

What is hydrothorax? What commonly causes it?

Answer 19

Transudate in the pleural cavity caused by congestive heart failure, kwashiorkor, and nephrotic syndrome

Question 20

A 17 year old female patient presents to the ER with left sided chest pain. She is gaunt with a distended abdomen. She reveals that she is a vegan and considers spicy sweet chili Doritos as her protein of choice. Aspiration of the pleural cavity of the left lung revealed a fluid with low specific gravity and low cells. What is the diagnosis?

Answer 20

Hydrothorax (transudate) pleural effusion

Question 21

Congestive heart failure can cause what kind of pleural effusion?

Answer 21

Hydrothorax

Question 22

Nephrotic syndrome and kwashiakor can cause what kind of pleural effusion?

Answer 22

Hydrothorax

Question 23

What is hemothorax?

Answer 23

Blood in the pleural cavity

Question 24

What can cause hemothorax?

Answer 24

Ruptured aortic aneurysm or trauma

Question 25

What is chylothorax? What can cause it?

Answer 25

Lymph obstruction causing a transudate effusion of the pleural cavity often due to obstruction by a tumor

Question 26

What is the radiographic sign of a pleural effusion?

Answer 26

Meniscus sign

Question 27

What is the main cause of malignant mesothelioma?

Answer 27

Asbestos

Question 28

Asbestos has a short latency period (TRUE/FALSE)?

Answer 28

FALSE

Question 29

What cells are present in an epithelioid mesothelioma?

Answer 29

Cuboidal, columnar, or flattened cells resembling adenocarcinoma

Question 30

What cells are present in a sarcomatoid mesothelioma (mesenchymal type)?

Answer 30

Spindle cell sarcoma resembling fibrosarcoma