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Year 1- Respiratory > Pleural Disease > Flashcards

Pleural Disease Flashcards

1
Q

Describe the structure of the pleura.

A

Glistening, smooth, thin membrane which covers the thoracic cavity and the lung

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2
Q

RECAP- name the pleura on the outside of the lung

A

Parietal

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3
Q

RECAP- name the pleura on the inside of the lung.

A

Visceral

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4
Q

What is found between the parietal and visceral pleura?

A

Plural fluid

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5
Q

What process produces pleural fluid?

A

Filtration

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6
Q

Name some of the cells found in pleural fluid.

A

Macrophages, lymphocytes, mesothelial cells

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7
Q

What type of pressure does the pleura have?

A

Subatmospheric pressure

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8
Q

What part of the lung has the most negative pressure?

A

Apex

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9
Q

RECAP- what is the collection of fluid in the pleural cavity called?

A

Pleural effusion

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10
Q

RECAP- what is a collection of air in the pleural cavity known as?

A

Pneumothorax

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11
Q

What is the term for pleural malignancy?

A

Mesothelioma

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12
Q

What is a combination of water and air in the parietal cavity known as?

A

Hydropneumothorax

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13
Q

Why does pleural effusion occur?

A

Imbalance between production and absorption

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14
Q

Name the two types of pleural effusion.

A

Transudate
Exudate

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15
Q

Is transudate non-inflammatory or inflammatory?

A

Non-inflammatory

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16
Q

Is exudate inflammatory or non-inflammatory?

A

Inflammatory

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17
Q

Which type of pleural effusion has a high protein content?

A

Exudate

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18
Q

What is the protein content of exudate?

A

3g/dl or more

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19
Q

Which criteria can determine if pleural effusion is exudate/

A

Light’s criteria

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20
Q

Name two very common causes of transudates.

A

Left ventricular failure
Liver cirrhosis

(she said we need to know three so one less common cause is Nephrotic syndrome)

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21
Q

Name some common causes of exudates.

A

Malignancy ( Pulmonary and non pulmonary)
Parapneumonic effusions, empyema
Tuberculosis

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22
Q

What tests can be used to diagnose pleural effusion?

A

Ultrasound
Chest x-ray
CT thorax

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23
Q

List the advantages of using an ultrasound.

A

More sensitive than CXR , mark site for aspiration, assess pleura, bedside

24
Q

List the advantages of using a chest x-ray

A

Accessible , easy to interpret

25
List the advantages of using a CT of the thorax.
Allows better look at complex effusions , visualising the pleura , vascular and mediastinal structures
26
Discuss the process of pleural fluid analysis.
Collect a sample via aspiration Inspect the fluid-> pus, blood etc. Check pH on bedside ABG machine
27
What do you do if the pH of the sample is <7.2?
May need chest drain
28
What is a primary spontaneous pneumothorax?
Spontaneous rupture in normal lungs
29
What is a secondary spontaneous pneumothorax?
Rupture occurs in someone with a pre-existing condition
30
Which pre-existing lung diseases may lead to a secondary spontaneous pneumothorax?
Interstitial lung disease COPD Asthma Cystic fibrosis
31
What is a traumatic pneomothorax?
Pneumothorax as a result to injury
32
What is an iatrogenic pneumothorax?
As a result to a procedure like lung biopsies.
33
What is a tension pnuemothorax?
Air builds up and pushes structures, like the trachea, and squashes the other lung and puts pressure on the heart.
34
Which type of pneumothorax can be very dangerous?
Tension pneumothorax
35
Who usually gets a primary spontaneous pneumothorax?
Tall, thin, young men. uh oh good luck jmatt
36
What are the presenting symptoms of a spontaneous pneumothorax?
Chest pain or breathlessness
37
What would you commonly see during examination in someone with a pneumthorax?
Breathing fast : tachypneic Hypoxic Reduced chest wall movement and reduced or no breath sounds Not uncommonly examination may be normal
38
When would you choose to observe a patient w a pneumothorax?
If they are well and the size of the pneumothorax is small
39
When would you choose to collect a sample (aspiration) from a patient with pneumothorax?
Pneumothorax over 2 cm in size , patient well
40
When would a patient be given surgery for pneumothorax?
Recurrent events, unresolving
41
What is a management option for those in hospital and requires anaesthetic?
Chest drain insertion
42
Where is it safe to do a pleural aspiration/ drain?
2nd intercostal space, midclavicular line
43
Are most pleural tumours benign or maligant?
Malignant
44
What is meant by secondary pleural malignancy?
Malignancy has developed as a result of cancer elsewhere in the body.
45
What is the most common primary malignant tumour?
Mesothelioma
46
Why may mesothelioma arise?
In some cases, by a mutation. More commonly, due to the inhalation of asbestos dust and fibres.
47
How does asbestos cause the formation of tumours?
Inhaled fibres reach the pleura and cause inflammation hence causing a tumour to form
48
How long after inhaling asbestos can mesothelioma develop?
20-40 years
49
Name some symptoms that suggest a mesothelioma has developed.
Breathlessness Weight loss Chest pain Clubbing, sign of pleural effusion
50
What could you do for the diagnosis of a mesothelioma?
Biopsy CT Thorax Thoracoscopy
51
Discuss management options for mesothelioma.
Incurable Treating the effusion Chemo Palliative surgery for some Recruitment to trials
52
What is the only imaging modality that allows a site for drainage of a pleural effusion to be marked?
Ultrasound
53
What are pleural plaques?
Benign areas of thickened tissue in the pleura
54
When may a person develop pleural plaques?
20-40 years after exposure to asbestos
55
What is the treatment for pleural plaques?
No treatment unless very large.
56
List some more general causes of transudates.
Heart failure Nephrotic syndrome Constrictive pericarditis Cirrhosis
57
List some more general causes of exudates.
Lung malignancy Pneumonia Mesothelioma Rheumatoid arthritis.

Year 1- Respiratory (36 decks)

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