Pleural Disease Flashcards
What are the different layers of the pleura?
outer - parietal
inner - visceral
in between - pleural fluid
What are different examples of pleural problems?
- pleural effusion
- pneumothorax
- mesothelioma
What is a pleural effusion (PE)?
- collection of fluid in the pleural space
- imbalance between production and absorption
- absorption: pleural lymphatics in the parietal pleura
What are different types of effusion?
- transudate: non inflammatory
- exudate: inflammatory
- protein content of exudate: 3g/dl or more
What are common causes of transudates?
- left ventricular failure
- liver cirrhosis
What are less common causes of transudates?
- hypoalbuminaemia
- peritoneal dialysis
- hypothyroidism
- nephrotic syndrome
- mitral stenosis
What are rare causes of transudates?
- constrictive pericarditis
- urinothorax
- Meigs’ syndrome
What are common causes of exudates?
- malignancy (pulmonary and non pulmonary)
- parapneumonic effusions, empyema
- tuberculosis
What are less common causes of exudates?
- pulmonary embolism
- connective tissue disease
- benign asbestos pleural effusion
- pancreatitis
- post-myocardial infarction
- post-coronary artery bypass graft
- haemothorax, chylothorax
What are rare causes of exudates?
- yellow nail syndrome (and other lymphatic disorders e.g. lymphangioleiomyomatosis)
- drugs
- fungal infections
What to do when the pH of pleural fluid is less that 7.2 along with pneumonia, pus or blood?
Chest drain
What are different types of pneumothorax’s?
- primary spontaneous
- secondary spontaneous
- traumatic
- latrogenic
- tension
What are the symptoms of a tension pneumothorax?
- chest pain
- SOB
- rapid heart rate
- shallow breathing
- anxiety
- blue or ashen skin
Where is a drain placed?
2nd intercostal space midclavicular line
What are factors associated with pleural tumours?
- benign: rare
- malignant pleural effusions are common and associated with a poor outcome
- primary malignancy: mesothelioma is the most frequent
