Lung abscess and pleural effusion Flashcards
What is the most common cause of a primary lung abscess?
Aspiration of infected material
What type of abscess occurs in debilitated patients?
post-pneumonic abscess (preceding bacterial infection)
What type of abscess occurs distal to bronchial tumor or foreign body?
Post-obstructive abscess (due to bronchial obstruction)
What causes an abscess that originates from thrombophlebitis or bacterial endocarditis?
Septic embolism
What type of abscess is caused due to infection with entamoeba histolytica?
Amoebic abscess
What is the most common site of an abscess due to aspiration?
right lung (single abscess)
If a patient presents with scattered lung abscesses, what could be your diagnosis?
preceding pneumonia or pyaemic
a patient presets with a cavity in the lung containing pus. On microscopic examination destruction with suppurative inflammation is seen surrounded by neutrophils. What is your diagnosis?
acute lung abscess
What is the microscopic feature of a chronic lung abscess?
destruction with suppurative inflammation surrounded by lymphocytes, plasma cells, and macrophages (the more chronic the more fibroblastic proliferation)
What are the clinical features of a lung abscess?
- fever
- malaise
- loss of weight
- clubbing of fingers and toes
- cough
- foul smelling sputum
- hemoptysis
- secondary amyloidosis in CHRONIC
what is the normal amount of fluid that lubricates the pleural surface?
15mL of serous acellular fluid
if there is an increase of hydrostatic pressure, what may be the reason behind pleural effusion?
congestive heart failure
decreased osmotic pressure is caused by what?
nephrotic syndrome
pneumonia may cause pleural effusion by what mechanism?
increasing vascular permeability
if there’s a decrease in lymphatic drainage, what could cause pleural effusion?
mediastinal carcinomatosis
what are the non-inflammatory types of pleural effusion?
1- hydrothorax
2- pneumothorax
3- chylothorax
if an accumulation of milky fluid of lymphatic origin is found, which type of pleural effusion could it be and what could have caused it
- chylothorax
- caused by rupture of thoracic duct by trauma OR obstruction of thoracic duct by malignancy
What are the inflammatory types of pleural effusion?
1- serous, fibrinous, & serofibrinous
2- suppurative pleuritic (EMPYEMA THORACIS)
3- hemorrhagic pleuritis
if a patient had trauma to his/her chest wall, what could be caused and what should u do?
- Haemothorax
- remove blood ASAP so it doesn’t clot and organize causing fibrous adhesions and obliteration of pleural cavity
A patient presents with Meig’s syndrome, fluid is straw-colored and has characteristic transudate features, what type of pleural effusion could she have? what other diseases could cause it?
- hydrothorax
- could be cause by congestive heart failure, liver cirrhosis, or renal failure
a patient presents with pleurisy and has a history of collagen disease, what is your diagnosis? What are other causes that may cause this?
serous, fibrinous, and serofibrinous pleuritis
- may be caused by infection or irradiation of lung tumors
A patient presented with a subdiaphragmic abscess, yellow-green exudate, and granulation tissue. Diagnosis?
Empyema thoracic (suppurative pleuritis)
other causes:
- bacterial or fungal infection
- direct spread of pyogenic infection from lung
- direct extension from liver abscess
- penetrating injury to chest wall
A patient has history of Rickettsial disease, what type of pleural effusion could he have? what is another cause for this type?
Hemorrhagic
metastatic involvement of pleura
