Pleural disease Flashcards

1
Q

What are the types of pleural disease?

A

Effusion
Pneumothorax
Empyema
Haemothorax
Mesothelioma

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2
Q

What is pleural effusion?

A

Excess fluid in pleural space

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3
Q

What are the 2 types of pleural effusion?

A

Transudates
Exudates

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4
Q

What are the features of transudate pleural effusion?

A

Non inflammatory
Low protein
Imbalance of hydrostatic forces influencing production and absorption of pleural fluid

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5
Q

What causes transudate pleural effusion?

A

Hypalbuminaemia
Cardiac failure
Liver failure
Renal failure

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6
Q

What are the features of exudate pleural effusions?

A

Inflammatory
High protein
Increased permeability of pleural surface or local capillaries

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7
Q

What are the cause of exudate pleural effusion?

A

Malignancy
Parapneumonic effusions
Empyema
Tuberculosis

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8
Q

What are the symptoms of pleural effusion?

A

SoB
Cough
Pleuritic chest pain

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9
Q

What are the signs of pleural effusion?

A

Decreased breath sounds
Decreased tactile fremitus
Decreased chest expansion
Dull percussion
Tracheal deviation

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10
Q

What is the criteria for pleural effusion?

A

Light’s criteria

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11
Q

What is Light’s criteria?

A

Protein: pleural fluid/serum fluid ratio >0.5
LDH: pleural fluid/serum fluid ratio>0.6
Pleural fluid LDH>2/3 ULN serum LDH

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12
Q

What are the investigations for pleural effusion?

A

Ultrasound
CXR
CT thorax
Aspiration- analyse biochemistry, microbiology and cytology

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13
Q

What is pneumothorax?

A

Collection of air in pleural space

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14
Q

What are the symptoms of pleural effusion?

A

Chest pain
SoB
Tachypnoea

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15
Q

What are the signs of pleural effusion?

A

Hype resonant percussion
Reduced breath sounds
Reduced chest expansion
Deviated trachea

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16
Q

What is the management of pneumothorax?

A
  1. Observe
  2. Aspiration- 2nd intercostal space, midaxillary line
  3. Chest drain
  4. Surgery
17
Q

What is pleurodesis?

A

Talc purdage used on pleural space to prevent further collection of fluid/air

18
Q

When is pleurodesis indicated?

A

Second ipsilateral pneumothorax
First contralateral pneumothorax
Bilateral spontaneous pneumothorax
First pneumothorax in high risk professions

19
Q

What is mesothelioma?

A

Rare, aggressive incurable cancer attacking the mesothelium

20
Q

What is mesothelium?

A

Epithelium lining the pleura, peritoneum and pericardium

21
Q

What causes mesothelioma?

A

Asbestos

22
Q

What are asbestos?

A

Cause inflammation of pleura, provoking uncontrolled cell growth
Mesothelial cancerous plaques start to cover pleura

23
Q

What are the signs and symptoms of mesothelioma?

A

Breathlessness
Chest pain
Weight loss
Clubbing
Signs of pleural effusion

24
Q

What does CXR of mesothelioma show?

A

Pleural effusion
Pleural based mass

25
Q

What does CT of mesothelioma show?

A

Thickened pleura
Pleural nodules/masses/plaques

26
Q

What does CT of mesothelioma show?

A

Thickened pleura
Pleural nodules/masses/plaques

27
Q

What is the management of mesothelioma?

A

Palliative
Treat effusion
Chemotherapy