PE, pneumothorax and pleural effusion Flashcards
1
Q
What is pleural disease?
A
- inflammation of the pleura
- pain (sharp, worse on inspiration, coughing, bending, twisting)
- pleural rub overlying inflammation
2
Q
Underlying causes of pleural disease
A
- infection/pneumonia
- TB
- infarction (PE)
- neoplasm (bronchial carcinoma, mesothelioma, lymphome
- other: rheumatoid arthritis, SLE
- asbestos related (plaques,diffuse pleural thickening)
3
Q
Signs of pleural effusion
A
reduced chest wall expansion on affected side
reduced vocal fremitus
mediastinal shift away from effusion
stony dull percussion
reduced breath sounds and vocal resonance on auscultation
4
Q
what is pneumothorax
A
- air within pleural cavity (less of negative pressure, lung deflated under natural elastic recoil
5
Q
signs of pneumothorax
A
- raised respiratory rate
- crackling under skin
- deviation away from side if large/tension
- reduced vocal fremitus
- hyper resonant
- auscultation (reduced breath sounds, reduced vocal resonance, hammans sign)
6
Q
What is pulmonary embolus
A
pulmonary vasculature clot
7
Q
symptoms of PE
A
- sudden onset SOB
- pain (central or pleuritic)
- haemoptysis
- circulatory collapse/LOC
8
Q
signs of PE
A
- raised resp rate
- unilateral leg pain and swelling
- pleural rub
- signs of pleural effusion
9
Q
What can be found on an X-ray in someone with PE?
A
- often normal
- blunting costophrenic angle
- Fleischers sign
- Westermark sign
- wedge infarction (hamptons hump)
10
Q
What ECG changes can be found in someone with PE
A
- sinus tachycardia
- RV strain
- incomplete right BBB
- inverted T waves anteriorly
11
Q
What is the Wells criteria
A
objectifies risk of PE
12
Q
systemic enquiry during a respiratory history
A
General: weight loss/gain, appetite, fevers/sweats CNS: headache, sleep ENT: nasal symptoms (rhinitis) GIT: reflux/dyspepsia, bowels GUT: nocturnal, incontinence M/S: joints/skin/hair
