Disorder of the Pleura

Question 1

What is the leading cause of transudative pleural effusion? (Harrison pp 1716)

Answer 1

Left ventricular Failure

Cirrhosis

Question 2

What is the leading cause of exudative pleural effusion? (Harrison pp 1716)

Answer 2

Bacterial
Malignancy
Viral Infection
Pleural Effusion

Question 3

What are the criteria of exudative pleural effusion? (Harrison pp 1716)

Answer 3

Pleural (Protein)/Serum (Protein) > 0.5
Pleural (LDH)/ Serum (LDH) >0.6
Pleural Fluid LDH > 2/3 of upper limit of the Normal

Question 4

Difference between the protein levels in the serum and pleural fluid is > 31 g/L (3.1g/dL) is transudative (Harrison pp 1716)
True or False

Answer 4

True

Question 5

What should be consider if the glucose of pleural fluid is <60mg/dl? (Harrison pp 1717)

Answer 5

M alignancy
R heumatoid pleuritis
B acterial infections

Question 6

_______ is virtually diagnostic that the effusion is secondary to congestive heart failure. (Harrison pp 1717)

Answer 6

NT- pro BNP > 1500 pg/ml

Question 7

Parapneumonic effusion are associated with the following (Harrison pp 1717)

Answer 7

Bacterial pneumonia
Lung abscess
Bronchiectasis

Question 8

Grossly purulent effusion (Harrison pp 1717)

Answer 8

Emphysema

Question 9

Indications for thoracentesis (Harrison pp 1717)

Answer 9

Gross pus 
Positive gram stain or culture
Pleural fluid glucose < 3.3 mmol/L
Pleural fluid pH < 7.20
Loculated pleural fluid

Question 10

2nd most common type of exudative (Harrison pp 1717)

Answer 10

Metastatic disease

Question 11

3 tumors that cause 75% of all malignant pleural effusion (Harrison pp 1717)

Answer 11

Breast Carcinoma
Lung Carcinoma
Lymphoma

Question 12

In pulmonary embolism, the pleural fluid is almost always exudate. (Harrison pp 1717)
True or False

Answer 12

True

Question 13

In most part of worlds the most common cause of an exudative pleural effusion is _______ (Harrison pp 1718)

Answer 13

Tuberculosis

Question 14

How high should be the level of TB markers in the pleural fluid? (Harrison pp 1718)

Answer 14

Adenosine deaminase > 40 IU/L

Interferon gamma > 140 pg/ml

Question 15

The most common cause of chylothorax (Harrison 1718)

Answer 15

Trauma (Thoracic surgery)

Question 16

In chylothorax, the triglyceride level should be level at _______. (Harrison pp 1718)

Answer 16

Exceeds 1.2 mmol/L

110mg/dl

Question 17

Transudative pleural effusion (Harrison pp 1718)

Answer 17

Congestive Heart Failure 
Cirrhosis 
Nephrotic syndrome
Peritoneal dialysis
SVC obstruction 
Myxedema
Urinothorax

Question 18

Drug induced pleural disease (Harrison pp 1718)

Answer 18

Nitrofurantoin 
Dantrolene 
Methysergide
Bromocriptine 
Procabazine 
Amiodarone
Dasatinib

Question 19

Rupture of apical pleural blebs, small cystic space and almost exclusively in SMOKERS (Harrison 1719)

Answer 19

Primary spontaneous pneumothorax

Question 20

Pneumothorax are due to chronic obstructive pulmonary disease (Harrison 1719)

Answer 20

Secondary pneumothorax