Disorders of the pleura Flashcards
What symptoms would you expect in a pleural effusion?
Might be asymptomatic but you can have CP or dyspnea
What would you expect to find on exam with a pleural effusion?
Dullness to percussion over the effusion and decreased BS
Increased production of fluid with NORMAL capillaries due to increased hydrostatic or decreased oncotic pressures is defined as?
transudate
increased production of fluid with abnormal capillary permeability is defined as?
exudative
infection in the pleural space
empyema
bleeding into the pleural space
hemothorax
What are some causes of transudative pleural effusion?
CHF or liver disease, cirrhosis
What are some causes of exudative pleural effusion?
PNA, malignancy, viral, fungal or bacteria infection.
What can happen to the trachea in the instance of a large pleural effusion?
pressure may cause tracheal shift/deviation toward pleural effusion side
What will the fluid show for an exudative pleural effusion?
the ratio of pleural fluid protein to serum protein will be greater than 0.5; ratio of pleural fluid LD to serum will be greater than 0.6.
What is the first thing you should suspect in a trauma patient with a pleural effusion?
hemothorax!
How do you diagnosis a hemothorax?
pleural fluid contains >50% hematocrit than that of peripheral blood
Tx for hemothorax
Drainage with large bore thoracostomy tubes; surgery may be required
What can cause superior vena caval syndrome?
mediaastinal tumors, lymphomas or a lung carcinoma with direct extension, aortic arch aneurysm
Clinical presentation of superior vena cava syndrome
swelling, flushing ,cyanosis of neck, face, arms
Headache, dizziness, syncope
Bending or lying down accentuates sxs
