Pleural disease

Question 1

causes of pleural effusion.

Answer 1

imbalance between production and absorption

Question 2

management of common causes of pleural effusion.

Answer 2

clinical history and examination

Question 3

the approach to investigation of a pleural effusion.

Answer 3

ultrasound, CXR, CT thorax for complex ones, pleural fluid analysis (aspiration)

Question 4

management of common causes of pleural effusion. if transudate

Answer 4

treat underlying cause

Question 5

pleural malignancy is called

Answer 5

mesothelioma

Question 6

types of effusion

Answer 6

transudate, exudate

Question 7

causes of transudates

Answer 7

heart and liver problems usually, rarely pulmonary

Question 8

causes of exudates

Answer 8

pulmonary causes eg empyema, TB, malignancy etc or some others eg pancreatitis,

Question 9

types of effusion

Answer 9

transudate (non inflammatory), exudate (inflammatory)

Question 10

causes of transudates

Answer 10

heart and liver problems usually eg left ventricular failure, live cirrhosis, hypoalbuminaemia, rarely pulmonary

Question 11

causes of exudates

Answer 11

pulmonary causes eg empyema, TB, malignancy etc or some others eg pancreatitis

Question 12

Pleural fluid analysis

Answer 12

aspiration, find pH, find dehydrogenase and glucose levels etc, inspect the fluid

Question 13

if PH less than 7.2 with pneumonia, pus or blood

Answer 13

may need a chest drain

Question 14

management of common causes of pleural effusion. if exudate

Answer 14

further investigations for identifying cause eg pleural biopsy or further imaging,

Question 15

illnesses that cause pneumothorax

Answer 15

asthma, copd, interstitial lung disease, cystic fibrosis, pleural endometriosis

Question 16

types of pneumothorax

Answer 16

primary spontaneous, secondary spontaneous, traumatic, iatrogenic, tension

Question 17

presentation of pneumothorax

Answer 17

sudden event, chest pain or breathlessness, tall thin young men, underlying lung disease, history of biopsy/ line insertion/ mechanical ventilation

Question 18

examination of pneumothorax

Answer 18

breathing fast, hypoxic, reduced chest wall movement, no breath sounds or reduced, hyper-ressenant note when tap, CXR

Question 19

management of pneumothorax

Answer 19

observe if really well, aspiration if patient is well, chest drain insertion, surgery if recurrent

Question 20

where does plural aspiration or drain go

Answer 20

2nd intercostal space midclavicular line

Question 21

pleural effusion is

Answer 21

increase in fluid in pleural space

Question 22

pneumothorax is

Answer 22

presence of air or gas in pleural space

Question 23

mesothelioma signs

Answer 23

rare, aggressive. breathlessness, chest pain, weight loss, clubbing

Question 24

causes of mesothelioma

Answer 24

inhaled asbestos fibres reach the pleura and cause inflammation provoke tumour formation. seen in plumbers, electricians, shipbuilding, power plants, boilers etc

Question 25

diagnosis of pleural tumours by

Answer 25

ct thorax, biopsy, cxr

Question 26

management of mesothelioma

Answer 26

treatment is limited, chemotherapy, recruitment to trials, palliative surgery sometimes, palliative care as survival is poor

Question 27

pleural plaques are

Answer 27

benign areas of thickened tissue that forms in the pleura or lung lining. due to exposure to asbestos. usually do not require treatment

Question 28

pleural fibrosis is

Answer 28

thickening and stiffening of the pleura that occurs as a result of pleural inflammation or exposure to asbestos