Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MHD > Pleural Disease > Flashcards

Pleural Disease Flashcards

1
Q

What is the normal pleural pressure? Why is it negative?

A

-5 cmH2O

It is negative due to the competing elastic recoils of the chest (outward) and lung (inward)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What determines the filtration coefficient of the pleura? When might it be increased?

A

“How leaky the pleura are”

May be increased in infection, inflammation, malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What could cause an increase in Pulmonary capillary hydrostatic pressure leading to effusion?

A

LV failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What could cause a decrease in pulmonary capillary oncotic pressure leading to effusion?

A

Cirrhosis
Malnutrition
Hypoalbuminemia
Nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What could cause a decrease in the pleural hydrostatic pressure leading to effusion?

A

Atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some physical exam findings of pleural effusion?

A

Dullness to percussion
Decreased breath sounds
Tactile fremitus
Egophony (e -> a change)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How might a pleural effusion be visualized on a CXR?

A

Blunting of the costophrenic angle

Meniscus sign

White out

Lateral decubitus position shows laying of fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a loculation? How is it treated?

A

Inflammatory pleural effusion due to infection that is well circumscribed because the area around it has fused and locked it in place.

Loculations require surgical intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can you determine the difference between a pleural effusion and atelectasis on CXR?

A

You may see complete white out in both.

Look at the mediastinum. The mediastinum would shift towards atelectasis, but away from a pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is the needle inserted in a thoracentesis?

A

OVER the rib (avoid the neurovascular bundle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are Light’s Criteria for determining if an effusion is exudate?
What is the one new “revised” criteria?

A

TPpl/TPserum greater than 0.5

LDHpl/LDHserum greater than 0.6

LDH greater than 200

Cholesterol(pl) greater than 45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the most common causes of transudative effusions?

A

Heart failure
Kidney failure
Liver failure
Atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is an empyema? How is it different from a parapneumonic effusion?

A

Empyema - Infection in the pleural space

In a parapneumonic effusion, the infection is in the lung itself, which cause a pleural effusion. The pleura are not infection in a parapneumonic effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can be determined by the pH of the pleural fluid?

A

Low pH may be seen with infection (empyema), malignancy, and esophageal rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you determine a hemothorax?

A

Blood in the pleural space

Pleural fluid hematocrit would need to be 0.5 or greater than peripheral hematocrit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe characteristics of a TB effusion

A 
Exudative
Lymphocytic
Less than 5% mesothelial cells
Positive ADA
TB skin test may be negative early on
17
Q

Describe characteristics of a Malignant Effusion

A 
Exudative
Lymphocytic
RBCs present
May have low pH and glucose
Large effusion with tendency to reaccumulate
18
Q

Describe characteristics of a Pulmonary embolism-related effusion

A

Small
Unilateral
Exudative
May be bloody

19
Q

Describe characteristics of an Esophageal Rupture effusion

A

Left sided
Low pH
High amylase

20
Q

Describe characteristics of an Endometriosis-related effusion

A

Bloody

May have hemoptysis

21
Q

Describe characteristics of a “Hepatic” effusion

A

Underlying cirrhosis
Transudates
R more common the L
Rapidly reaccumulates

22
Q

How could an empyema be definitively diagnosed?

A

Milky white effusion with
Positive Gram stain
Positive culture
Pus

23
Q

How is a chylothorax distinguished from a pseudochylothorax?

A

Both are milky white effusions

Chylothorax (TG over 110)- due to malignancy, trauma, mediastinal disease

Pseudochylothorax (TG over 100 and Chol over 200)- due to chronic inflammation

24
Q

Describe the basic mechanism of a pneumothorax

A

Either the alveoli get punctured or there is a hole in the chest wall, resulting in air rushing into pleural space.

Lungs collapse inward
Chest wall bulges out

25
Q

How can a pneumothorax be at risk for tension?

How does tension pneumothorax kill you?

A

Ball valve mechanism
Breathe in, hole in chest wall closes, more air trapped inside the pleural space.

High intrathoracic pressure impedes venous return. No blood returns to the heart and you go into shock and die

26
Q

Pneumothorax

Symptoms

A 
May be asymptomatic
Chest pain
Discomfort
Dyspnea
Cough
Shock (if tension)
27
Q

Pneumothorax

Physical Exam findings

A

Unilateral hyperinflation
Decreased breath sounds and tactile fremitus
Hyperresonance

28
Q

Pneumothorax

CXR Findings

A

Hyperlucent lung fields
Lack of lung markings
Shift of mediastinum if tension

29
Q

Pneumothorax (asymptomatic)

Treatment

A

Observation

Give them 100% O2

30
Q

Pneumothorax (symptomatic)

Treatment

A

Drain the pneumothorax with a chest tube

MHD (57 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions