Pleural Disease Flashcards
what are pleural plaques
incidental, benign findings
marker od previos asbestos exposure
what are the sings/symptoms of a malignant mesothelioma
chest pain
SOB
fever
weskness
cough
weight loss
what is a malignant mesothelioma
uncommon cancerous tumour.
affects the pleura
what are some diseases that can casue pleural effusion
congestive heart failure
pneumonia
TB
cancers
what is a pleural effusion
buikd up off excess fluid in the pleura
what is pneumonia
lung inflammation caused by bacterial or viral infection, in which the air sacs fill with pus and may become solid.
what would you see on the chest X ray
loss of costophrenic angle (mainly)
tracheal deviation
what is the normal colur of plural fluid
straw
what is the colour of abnormal fluid
cloudy
what would cloudy pleural fluid suggest
an exudate
high in protein
(Egg- udate)
what does a exudate pleural effusion sugesst
infection
malignancy
what does a transudate pleural effusion suggest
cardia failure
liver failure
renal failure
as its more H2O
when should a pleural effusion be drained
large effusion
parapneumonic - PH <7.2
pus - infection
trauma/ post operative
what are the signs/symptoms of a large pleural effusion
SOB, tachypnoea, hypoxia, tachycardia
Chest X-ray trachea deviated
how do you drain a pleural effusion
with a chest tube
where should the chest tube be placed
4th intercostal
anterior auxiliary
onto of the 4th rib avoid nerves, and blood vessels below 3rd rib
what can you use for recurrent pleural effusions
a catheter
steritalc - sterile talcon powder
what is a parapneumonic effusion
a type of pleural effusion that arises as a result of a pneumonia, lung abscess, or bronchiectasis.
what are the two types of pneumothorax
spontaneous
traumatic
what is a tension pneumothorax
a large pneumothorax causing cardiorespiratory compromise - can be any of the other types of pneumothorax
what are the two types of spontaneous pneumothorax
primary
secondary
what are the two types of traumatic pneumothorax
non-iatrogenic
iatrogenic
what are the causes of primary spontaneous pneumothorax
no pre-existing lung disease
young men
tall thin, smokers, cannabis
recurrent up to 25%
what are the cause of secondary spontaneous pneumothorax
older men
pre-existing lung disease
higher recurrence rate
what at are iatrogenic trauma pneumothorax
pneumothorax caused by surgery
what causes traumatic pneumothorax
blunt/penetrating
fractured ribs
stab wounds
what is the management of pneumothorax
do nothing
aspiration
O2 and chest drain
what is the long term control of a pneumothorax
home with chest drain
medical pleurodesis
what is pleurodesis
adhesion of the pleura
what are the sings and symptoms of a tension pneumothorax
hyper-resonance
hypoxia
tachycardia
hypotension
cardiac arrest
what are the treatment of tension pneumothorax
oxygen
aspirate
chest x-ray to confirm
what is advice to give on discharge
advice on recurrence
smoking cessation
flying
work (army, diver)
how would you diagnose a malignant mesothelioma
pleural effusion
pleural base opacity
CT imaging staging
biopsy for diagnosis
what is the prognosis of malignant mesothelioma
median survival - under a year
only really chemotherapy
palliation - pleurodesis, chest drain
how a pleural effusions drained
using a ultrasound for real time site marking before aspiration
