Lung abscess and pleural effusion

Question 1

What is the most common cause of a primary lung abscess?

Answer 1

Aspiration of infected material

Question 2

What type of abscess occurs in debilitated patients?

Answer 2

post-pneumonic abscess (preceding bacterial infection)

Question 3

What type of abscess occurs distal to bronchial tumor or foreign body?

Answer 3

Post-obstructive abscess (due to bronchial obstruction)

Question 4

What causes an abscess that originates from thrombophlebitis or bacterial endocarditis?

Answer 4

Septic embolism

Question 5

What type of abscess is caused due to infection with entamoeba histolytica?

Answer 5

Amoebic abscess

Question 6

What is the most common site of an abscess due to aspiration?

Answer 6

right lung (single abscess)

Question 7

If a patient presents with scattered lung abscesses, what could be your diagnosis?

Answer 7

preceding pneumonia or pyaemic

Question 8

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?

Answer 8

acute lung abscess

Question 9

What is the microscopic feature of a chronic lung abscess?

Answer 9

destruction with suppurative inflammation surrounded by lymphocytes, plasma cells, and macrophages (the more chronic the more fibroblastic proliferation)

Question 10

What are the clinical features of a lung abscess?

Answer 10

• fever
• malaise
• loss of weight
• clubbing of fingers and toes
• cough
• foul smelling sputum
• hemoptysis
• secondary amyloidosis in CHRONIC

Question 11

what is the normal amount of fluid that lubricates the pleural surface?

Answer 11

15mL of serous acellular fluid

Question 12

if there is an increase of hydrostatic pressure, what may be the reason behind pleural effusion?

Answer 12

congestive heart failure

Question 13

decreased osmotic pressure is caused by what?

Answer 13

nephrotic syndrome

Question 14

pneumonia may cause pleural effusion by what mechanism?

Answer 14

increasing vascular permeability

Question 15

if there’s a decrease in lymphatic drainage, what could cause pleural effusion?

Answer 15

mediastinal carcinomatosis

Question 16

what are the non-inflammatory types of pleural effusion?

Answer 16

1- hydrothorax
2- pneumothorax
3- chylothorax

Question 17

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

Answer 17

• chylothorax

- caused by rupture of thoracic duct by trauma OR obstruction of thoracic duct by malignancy

Question 18

What are the inflammatory types of pleural effusion?

Answer 18

1- serous, fibrinous, & serofibrinous
2- suppurative pleuritic (EMPYEMA THORACIS)
3- hemorrhagic pleuritis

Question 19

if a patient had trauma to his/her chest wall, what could be caused and what should u do?

Answer 19

• Haemothorax

- remove blood ASAP so it doesn’t clot and organize causing fibrous adhesions and obliteration of pleural cavity

Question 20

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?

Answer 20

• hydrothorax

- could be cause by congestive heart failure, liver cirrhosis, or renal failure

Question 21

a patient presents with pleurisy and has a history of collagen disease, what is your diagnosis? What are other causes that may cause this?

Answer 21

serous, fibrinous, and serofibrinous pleuritis

• may be caused by infection or irradiation of lung tumors

Question 22

A patient presented with a subdiaphragmic abscess, yellow-green exudate, and granulation tissue. Diagnosis?

Answer 22

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

Question 23

A patient has history of Rickettsial disease, what type of pleural effusion could he have? what is another cause for this type?

Answer 23

Hemorrhagic

metastatic involvement of pleura