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Medicine 1 Respiratory > Pleural Disease > Flashcards

Pleural Disease Flashcards

1
Q

What are some clinical findings of pleural disease?

A

Reduced breath sounds

Stony dull on percusion

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2
Q

What are some possible chest X-ray findings for pleural disease?

A

Loss of costophrenic ange

At least 200ml of pleural fluid

Tracheal deviation

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3
Q

What are some possible CT findings of pleural disease?

A

Nodular thickening

Pleural fluid/air

Density of fluid

Localisation

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4
Q

When investigating pleural fluid, in terms of biochemistry, what are you looking for?

A

Protein

LDH

Glucose

Triglyceride

Cholesterol

Amylase

Rheumatoid factor

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5
Q

When investigating pleural fluid, in terms of microbiology, are you looking for?

A

Gram stain

AAFB

Culture

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6
Q

What are the 2 kinds of extracellular fluid?

A

Transudate

Exudate

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7
Q

What is tranudate?

A

Extracellular fluid with a low protein count, occurs due to increase hydrostatic pressure

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8
Q

What does transudate occur due to?

A

Increase hydrostatic pressure

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9
Q

What is exudate?

A

Extracellular fluid with a high protein count, occurs due to inflammation and increase capillary permeability

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10
Q

What does exudate occur due to?

A

Inflammation and increased capillary permeability

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11
Q

Which of tranudate and exudate has more protein?

A

Exudate

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12
Q

Which of transduate and exudate has more LDH?

A

Exudate

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13
Q

What is LDH?

A

Lactate dehydrogenase

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14
Q

What is exudate associated with?

A

Infection

Malignancy

Pulmonary embolism

Rheumatoid arthritis

Effusions

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15
Q

What is transudate associated with?

A

Cardiac failure

Liver failure

Renal failure

Hypoalbuminemia

Hypothyroidism

Pulmonary embolism

Malignancy

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16
Q

What are different kinds of biopsy that can be used to obtain a sample of pleural fluid?

A

Abrams pleural bipsy

Image guided biopsy

Medical thoracoscopy

VATS pleural biopsy

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17
Q

What does VATS stand up for?

A

Video assisted thoracoscopic surgery

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18
Q

What is a pleural effusion?

A

Build up of fluid between the layers of the pleura

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19
Q

What is a build up of fluid between the two layers of the pleura called?

A

Pleural effusion

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20
Q

When should a pleural effusion be drained?

A

Large

Breathless

Raised respiratory rate

Hypoxia

Tachycardia

Chest X-ray trachea deviated

Pus

Trauma

Parapneumonic

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21
Q

What is a parapneumonic effusion?

A

Type of effusion that arises as a result of a pneumonia, lung abscess or bronchiectasis

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22
Q

What is the prognosis of parapneumonic effusion?

A

Poor outcome

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23
Q

What percentage of pleural effusions are parapneumonic effusions?

A

33%

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24
Q

What is a type of effusion that arises as a result of a pneumonia, lung abscess or bronchiectasis called?

A

Parapneumonic effusion

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25
Q

Where should the needle go (in regards to the rib) when obtaining a sample of pleural fluid?

A

Above the rib to avoid the nerve bundle

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26
Q

What is a pneumothorax?

A

Collapsed lung, occurs when air leaks into the pleura

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27
Q

What is a collapsed lung, occuring due to air leaking into the pleura called?

A

Pneumothorax

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28
Q

What are the 2 ways that a pneumothorax can occur?

A

Spontaneous

Traumatic

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29
Q

What are different kinds of traumatic pneumothorax?

A

Non-iatrogenic

Iatrogenic

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30
Q

What does iatrogenic mean?

A

Illness caused by medical examination or treatment

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31
Q

What is an illness caused by medical examination or treatment called?

A

Iatrogenic

32
Q

What does management of a pneumothorax include?

A

Nothing

Aspiration

Oxygen and chest drain insertion

33
Q

What does long term management of a pneumothorax include?

A

Home with chest drain

Medical pleurodeisis

Cardiothoracic referral

34
Q

What is a pleurodeisis?

A

Procedure that uses medicine to adhere your lung to your chest wall

35
Q

What is a procedure that uses medicine to adhere your lung to your chest wall called?

A

Pleurodeisis

36
Q

What is a tension pneumothorax?

A

Progressive build up of air within the pleural space, usually due to a lung laceration which allows air to escape into the pleural space but not return

37
Q

What is the progressive build up of air within the pleural spaced called?

A

Tension pneumothorax

38
Q

What is a laceration?

A

Deep cut or tear

39
Q

What is a deep cut or tear called?

A

Laceration

40
Q

What perentage of the time that a tension pneumothorax requires ventilation?

A

50%

41
Q

What are the signs of a tension pneumothorax?

A

Distressed

Trachea deviation

Reduced chest expansion

Hyper resonance

Hypoxia

Tachycardia

Hypotension

Cardiac arrest

42
Q

What do you aspirate for a tension pneumothorax?

A

2nd anterior intercostal space in the midclavicular line

43
Q

What advice should you speak about with a patient you are discharging?

A

Advice about recurrence

Smoking cessation

Flying

Return to work

Any follow up

44
Q

What is a well known chemical that can cause pleural disease?

A

Asbestos

45
Q

What are the 3 main highly fibrous materials that cause pleural disease?

A

Chrysotile (white)

Amosite (brown)

Crocidolite (blue)

46
Q

What colour is chrysotile?

A

White

47
Q

What colour is amosite?

A

Brown

48
Q

What colour is crocidolite?

A

Blue

49
Q

What is the most dangerous asbestos to health?

A

Crocidolite

50
Q

What is asbestos?

A

Group of minerals made of microscopic fibres, where if you breath in these fibres they can damage your lungs

51
Q

What are the group of materials made of microscopic fibres called?

A

Asbestos

52
Q

What is asbestos related pleural disease usually due to?

A

Occupation

53
Q

How long is the latent period?

A

20-40 years

54
Q

What are examples of occupations that might lead to asbestos related pleural disease?

A

Marine engineer

Ship building

Docks

Construction sites

Joiners

Plumbers

Engine rooms

Boilers

55
Q

What are examples of diseases caused by asbestos?

A

Pleural plaques

Benign asbestos effusion

Malignant mesothelioma

Diffuse pleural thickening

56
Q

What are pleural plaques?

A

Due to exposure to asbestos areas of the pleural membrane become thickened and accumulates a chalky material

57
Q

What is it called when due to asbestos areas of the pleural membrane become thickened and accumulates a chalky material?

A

Pleural plaques

58
Q

What may people who have pleural disease due to asbestos be entitled to?

A

Compensation

59
Q

Are pleural plaques benign or malignant?

A

Benign

60
Q

What is a benign asbestos effusion?

A

Non-malignant pleural disease

61
Q

What is benign asbestos effusion associated with?

A

Pleural thickening

62
Q

What is a malignant mesothelioma?

A

Cancer of the thin tissue (mesothelium) that lines the lung, chest wall and abdomen

63
Q

What is cancer of the thin tissue (mesothelium) that lines the lung, chest wall and abdomen called?

A

Malignant mesothelioma

64
Q

What are symptoms of malignant mesothelioma?

A

Chest pain

Breathlessness

Fever

Weakness

Cough

Weight loss

65
Q

What does the diagnosis of malignant mesothelioma use?

A

Chest X-ray

CT

Aspirate

Tissue required to confirm diagnosis

66
Q

What does a chest X-ray show for malignant mesothelioma?

A

Pleural effusion

Pleural based opacity/mass

67
Q

What is used to obtain tissue to confirm the diagnosis of malignant mesothelioma?

A

Image guided biopsy

Thoracoscopy

Lobectomy

68
Q

What is the median survival time for malignant mesothelioma?

A

Less than 1 year

69
Q

What is the treatment for malignant mesothelioma?

A

Limited role for surgery

Chemotherapy

Palliation

70
Q

What is diffuse pleural thickening?

A

Extension, often smooth scarring thickens the pleural membrane

71
Q

What is it called when smooth scarring thickens the pleural membrane?

A

Diffuse pleural thickening

72
Q

What is pleural fibrosis?

A

Thickening and stiffening of the pleural that occurs due to pleural inflammation or exposure to asbestos

73
Q

What is thickening and stiffening of the pleura that occurs due to pleural inflammation or exposure to asbestos called?

A

Pleural fibrosis

74
Q

What is empyema?

A

Collection of pus in the pleural cavity caused by microorganisms

75
Q

What is a collection of pus in the pleural cavity caused by microorganisms called?

A

Empyema

Medicine 1 Respiratory (20 decks)

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