pleural disease Flashcards
In what instance do you not drain your pleural effusion?
CHF
When does a transudative pleural effusion occur?
when systemic factors influence the formation and absorption of pleural fluid are altered (like CHF and cirrhosis)
When does an exudative pleural effusion occur?
local factors are altered (penumonia, malignancy)
Light Criteria for an exudate?
Pleural fluid protein to serum protein ratio > .5
pleural LDH to serum LDH >.6
Total pleural LDH > 2/3 upper limit of normal for serum LDH
Based one cell count, if exudative is more than 50% neutrophils what you got
acute process involving parapneumonic effusion, PE, pancreatitis
Based on cell count if greater than 50% lymphocytes…
chronic process (like TB or malignancy)
based on cell count if greater than 10% eosinophil…
blood or air in pleural space, drugs, churg-strauss (vascular something)
based on cell count if Hct 1-20% red cells…
cancer, PE, trauma
what is a chylothorax?
milky fluid in the pleural space, high triglyceride level.
results from disruption of thoracic duct (lymphoma, trauma, etc)
what are risk factors for primary spontaenous pneumothorax?
tall, thin, tobacco abuse…
due to rupture of apical pleural blebs or cystic spaces which lie within or right under visceral pleura
whats the most common cause of secondary spontaenous pneumothorax?
COPD! other = PCP in aids. more life threatening because underlying lung disease
what is a tension pneumothorax?
present with the intrapleural pressure exceeding atmopshereic pressure throughout expiration–> decreased ventilation, hypoxemia, decreased venous return, decreased cardiac output. deviated trachea!
