pleural disease Flashcards
1
Q
where does pleural fluid normally come from and go out
A
- comes in from intercostal and bronchial vessel system
- goes out the lymphatic drainage system
- most action on the parietal side
2
Q
what happens in CHF
A
transudate
- high pressure in blood vessels pushes fluid in
- high pressure blocks lymphatic drainage
- get more in than out
3
Q
what happens in inflammation
A
exudate
- high pressure from blood vessels
- cells wall separate and let proteins into the pleural space
4
Q
what happens in CA
A
exudate
- high pressure in vessels
- tumors can block lymphatics
- cytokines can cause walls to separate
5
Q
3 cauese of transudate
A
- CHF
- hepatic hydrothorax
- nephrotic syndrome
6
Q
4 general cause of exudate
A
- infection
- malig
- inflammatory
- other
7
Q
CXR signs of effusion
A
- blunting of costophrenic angle
- meniscus
- increased opacity
- pleural fluid layering out
8
Q
what is thoracentesis
A
- sampling of fluid
- can be done with local
9
Q
light’s crit. for exudate
A
it is exudate if any one of:
- pleural prot:serum protein >0.5
- pleural LDH:serum LDH >0.6
- LDH > 200
10
Q
what is high LDH sign of
A
- empyema
- RA
- malig
11
Q
what is high protein sign of
A
- TB
2. myeloma
12
Q
what is low pH sign of
A
- empymena
- TB
- RA
- malig.
- eso rupture
13
Q
what is low glucose sign of
A
- epymnema
- TB
- RA
- malig
- eso rupture
14
Q
what are 3 cell counts to look and and what do they tell us
A
Neutrophil - bacterial Lymphocyte - malig, TB Eosinophil - pneumo, hemothorax, drugs, parasites
15
Q
what is MGMT of transudate
A
TREAT underlying problem
- can also help reduce the afterload
