Brainscape's Knowledge GenomeTM

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


See full index

Respiratory system 2017 > Pleural disease > Flashcards

Pleural disease Flashcards

1
Q

What innervates the parietal pleura?

A

Phrenic nerves and intercostal nerves

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

What innervates the visceral pleura?

A

Vagus nerve and sympathetic fibres

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

What are both the pleura made up by?

A

Single layer of mesothelial cells and sub-pleural connective tissue

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

What is a pleural effusion?

A

Collection of fluid in pleural cavity

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

What are the symptoms of pleural effusions?

A 
Asymptomatic
SOB, increasing
Pleuritic chest pain, which can improve itself
Dull ache of chest
Dry cough
Weight loss
Malaise
Fever
Night sweats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the clinical signs of pleural effusions?

A 
Decreased chest movement on affected side
Decreased expansion
Stony dullness on percussion
Decreased breath sounds on affected side
Decreased vocal resonance
Clubbing
Cervical lymphadenopathy
Increased JVP
Tracheal shift
Peripheral oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the difference between transudates and exudates?

A

Transudates - changes in hydrostatic forces, protein <30g/L, often bilateral and systemic

Exudates - increased permeability, protein >30g/L, often unilateral

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

How do we determine if a pleural effusion is due to transudates or exudates if protein level is 25-35g/L?

A

Light’s criteria, exudate if 1 or more of following criteria is met:

  • pleural/serum protein >0.5
  • pleural/serum LDH >0.6
  • pleural LDH >0.66 of upper limit of serum LDH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When are pleural effusions caused by transudates common?

A 
Left ventricular failure
Liver cirrhosis
Hypoalbuminaemia
Peritoneal dialysis
Hypothyroidism
Nephrotic syndrome
Mitral stenosis
Pulmonary embolism
Constrictive pericarditis
Ovarian hyperstimulation syndrome
Meigs syndrome (benign ovarian fibroma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When are pleural effusions caused by exudates common?

A 
Malignancy
Parapneumonic effusion
PTE (more so than in transudates)
Rheumatoid arthritis
Benign asbestos effusion
Pancreatitis
Post MI
Yellow nail syndrome
Certain drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What drugs can cause exudates and pleural effusions?

A 
Amiodarone
Nitrofurantoin
Phenytoin
Methotrexate
Carbamazapine
Penicillamine
Bromocriptine
Pergolide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What investigations are carried out for pleural effusions?

A

Transudates - none unless they don’t respond

CXR - >200ml required to be detectable 
Contrast enhanced CT
Pleural aspiration and biopsy
Lab analysis of collected fluid 
Thoracoscopy
Direct inspection - can collapse lung
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some possible complications of pleural aspiration?

A 
Pneumothorax
Empyema
Pulmonary oedema
Vagal reflex
Air embolism
Tumour cell seeding
Haemothorax
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How many samples do you take for biopsy during pleural aspiration?

A

3 in formaldehyde for histology

1 in saline for TB tests and microbiology?

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

How do you treat pleural effusions?

A

Chemo - cancer or infection e.g. TB
Corticosteroids - inflammation
Repeat pleural aspirations
Pleurodhesis if recurrent or patient at risk

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

How much fluid can be removed at one time during pleural aspiration?

A

1-1.5L

17
Q

What is a pneumothorax?

A

Presence of air in the pleural cavity due to a breach in either the parietal or visceral pleura, causing an uncoupling of the lungs to the chest wall

18
Q

What is a tension pneumothorax?

A

When a pneumothorax of any cause leads to significant impairment of respiration and/or circulation

19
Q

What are the signs and symptoms of a tension pneumothorax?

A 
Chest pain
Respiratory distress
Tachycardia
Tachypnoea
Low O2 sats
Low blood pressure
Cyanosis
Hyperresonant percussion of chest
Reduced expansion and movement
Altered levels of consciousness
Displacement of apex beat
Displacement of the trachea
Reduced breath sounds
20
Q

In what population are primary pneumothorax usually seen?

A

Young tall thin men - thought to be due to weight go lung inducing development of apical pleural blebs that rupture, possibly due to a congenital defect of the connective tissue in the alveolar wall

21
Q

What diseases can cause secondary pneumothorax?

A 
COPD
Asthma
Pneumonia
TB
CF
Fibrosing alveolitis
Sarcoidosis
22
Q

What is the cut off between a small and a large pneumothorax?

A

Small - air rim <2cm

Large - air rim >2cm

23
Q

How do you treat pneumothorax?

A

Normally insert cannula in 2nd intercostal pace in mid-clavicular line and insert chest drain

24
Q

When do you refer patients with pneumothorax for surgery?

A

Second ipsilateral penumothorax
First contralateral pneumothorax
Bilateral spontaneous pneumothorax
First pneumothorax in high risk professions

25
Q

What are the 3 main types of asbestos?

A

Chrysotile (white)
Amosite (brown)
Crocidolite (blue)

26
Q

What colour is chrysotile?

A

White

27
Q

What colour is amosite?

A

Brown

28
Q

What colour is crocidolite?

A

Blue

29
Q

Which type of asbestos is the most dangerous to health?

A

Crocidolite (blue)

30
Q

What is the most widely used type of asbestos?

A

Chrysotile (white)

31
Q

Why is asbestos used in manufacturing?

A

High tensile strength
Fire resistance
Insulation to electrical charge
Resistant to chemical attack

32
Q

Who are at risk of exposure to asbestos?

A 
Boiler men
Engineers
Electricians
Plumbers
Building trade
Ship builders
Partners/family of those in these businesses
33
Q

How long after exposure to asbestos does asbestos related disease occur?

A

20-40 years later

34
Q

What disease can be caused by asbestos exposure?

A

Mesothelioma

35
Q

What is mesothelioma?

A

Pleural malignancy often caused by asbestos exposure, with patients presenting with breathlessness, chest wall pain and weight loss.

Respiratory system 2017 (31 decks)

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