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Respiratory System > Diseases of the Pleura > Flashcards

Diseases of the Pleura Flashcards

1
Q

What is the pleural

A

Single layer of mesothelial cells and the space between the parietal and visceral layers

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2
Q

What type of pressure is between the parietal and visceral

A

Negative pressure

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3
Q

How much pleural fluid is the lungs lubricated by

A

2-3ml

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4
Q

What is the dynamic turnover of pleural fluid

A

30-75% per hour

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5
Q

Straw coloured pleural effusion

A

Normal

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6
Q

Cloudy pleural effusion

A

Exudate

Infection

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7
Q

Milky pleural effusion

A

Chylothorax from lymph formed in the digestive system called chyle accumulating and disrupting the thoracic duct

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8
Q

Blood in pleural effusion

A

Malignancy
TB
Trauma
Infarct

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9
Q

Pus in pleural effusion

A

Empyema

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10
Q

Diagnostic tests

A

Biochemistry: protein, LDH, glucose, triglyceride, cholesterol,amylase, rheumatoid factor
Microbiology: Gram stain, ZN stain and culture
Cytology

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11
Q

What is transudate

A

fluid pushed through the capillary due to high pressure within the capillaries (high vascular hydrostatic or oncotic pressure)

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12
Q

Protein content with transudate

A

<2.5

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13
Q

What is exudate

A

fluid that leaks around cells of the capillaries caused by inflammation

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14
Q

Protein content in exudate

A

> 3.5

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15
Q

What is Dressler syndrome

A

pericarditis — inflammation of the sac surrounding the heart (pericardium). Believed to be an immune system response after damage to heart tissue or to the pericardium, from events such as a heart attack, surgery or traumatic injury

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16
Q

Features of Abrams pleural biopsy (4)

A

Beside
Local anaethesia
Blind
Diagnostic

17
Q

Features of Image guided biopsy (4)

A

Day case
Local anaesthesia
Image guided
Diagnostic

18
Q

Features of Medical thoracoscopy (4)

A

Sterile procedure room
Local and sedation
Direct visualisation
Pleurodesis

19
Q

What is a Pleurodesis

A

Pleurodesis is a procedure that uses medicine to adhere your lung to your chest wall. It seals up the space between the outer lining of your lung and chest wall (pleural cavity) to prevent fluid or air from continually building up around your lungs

20
Q

Features of a Vats pleural biopsy (4)

A

Theatre
General anaesthesia
Direct visualisation
Pleurodesis

21
Q

When should you drain an effusion (7)

A 
Breathlessness
Raised RR
Hypoxia
Tachycardic
CXR shows deviated trachea 
Pus
Trauma/post operative
22
Q

Where should the chest tube be placed

A

Above the rib to avoid the neural vascular bundle

23
Q

What pH should you carry out a drain and why

A

<7.2

This shows high infection as bacteria are producing lactic acid and causing the pH to decrease

24
Q

Management for pleural effusion

A

Do nothing (be careful of bullous lung disease)
Aspiration
Oxygen and chest drain insertion

25
Q

Long term treatment for pleural effusion

A

Home with chest drain
Medical pleurodesis using sclerosing agents
Cardiothoracic referral -VAT

26
Q

What is a tension pneumothorax

A

A large pneumothorax causing cardiorespiratory compromise

27
Q

Complications of tension pneumothorax

A 
Trachea deviated
Subcutaneous emphysema
Reduced chest excursion
Hyperresonance
Hypoxia
Tachycardia
Hypotension
Cardiac arrest
28
Q

Treatment for tension pneuothorax (3)

A

Oxygen
Aspirate in the 2nd anterior intercostal space in the midclavicular line
CXR and US to confirm

29
Q

Features of Asbestos related pleural disease

A 
Occupation
Latent period (20-40 years)
30
Q

Features of Pleural plaques (4)

A

Incidental findings
Benign
Marker of previous asbestos exposure
May be entitled to compensation

31
Q

Features of benign asbestos effusion (6)

A 
Diagnosis of exclusion
Exudate
Lymphocytic
May be blood stained
Can resolve spontaneously
Associated with pleural thickening
32
Q

Features of malignant mesothelioma

A 
Chest pain
SOB
Fever
Weakness
Cough
Weight loss
Blood stained effusion
RNS
ROS

Respiratory System (30 decks)

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