Brainscape's Knowledge GenomeTM

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


See full index

Block 31 Cardio-respiratory > Pleural Disease > Flashcards

Pleural Disease Flashcards

1
Q

What is pleural effusion?

A

excessive accumulation of fluid in the pleural space

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

what levels of fluid need to present for pleural effusion to be detected?

A

> 300mL on Xray

>500mL clinically

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

What may be seen on X-ray in a patient with pleural effusion?

A
  • obliteration of costophrenic angle
  • dense homogoneus shadows occupying part of hemithorax
  • fluid below the lung can simulate a raised hemidiaphragm
  • fluid in fissures-may resemble intrapulmonary mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is a diagnosis of pleural effusion made?

A

pleural aspiration with ultrasound guidance

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

what are the categories of effusion?

A

transudate

exudate

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

where are transudates usually found?

A

can be bilateral but are often larger on right side

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

what are the causes of transudate?

A 
heart failure
hypoproteinaemia
constrictive pericarditis
hypothyroidism
ovarian tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the protein, lactic dehydrogenase content and fluid to serum LDH ratio of transudate?

A

protein <30g/L
lactic dehydrogenase<200IU/L
fluid to serum LDH ratio is <0.6

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

what is the protein, lactic dehydrogenase content of exudate?

A

protein >30g/L

lactic dehydrogenase >200IU/L

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

What are the causes of exudates?

A 
bacterial pneumonia
carcinoma of bronchus
TB
autoimmune rheumatic diseases
post MI infarction
acute pancreatitis
mesothelioma
sarcoidosis
yellow nail syndrome
familial mediterranean fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the features of a history of a patient with pleural effusion?

A 
dyspnea
pleuritic chest pain
cough
fever
hemoptysis 
weight loss
trauma
history of cancer
cardiac surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the physical examination findings for a patient with pleural effusion?

A 
dullness to percussion
decreased breath sounds
absent tactle fremitus
ascites
JVP
peripheral oedema
friction rub
unilateral leg swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is pneumothorax?

A

air in the pleural space

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

what are the types of pneumothorax?

A

spontaneous

or due to trauma

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

spontaneous pneumothorax

  1. who gets it?
  2. what causes it?
A

1.common in young men. often in tall and thin patients
2. caused by rupture of a pleural bleb. usually apical and due to congenital defects in connective tissue of alveolar walls
underlying cause in patients over 40 is usually COPD

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

when is a pneumothorax localied?

A

if the visceral pleura has previously become adherent to parietal pleura

17
Q

when is a pneumothorax generalised?

A

if there are no pleural adhesions

18
Q

how does a bronchopleural fistula occur?

A

pressure in pleural space is usually negative and this is lost once a communication is made with atmospheric pressure, the elastic recoil pressure of the lung causes it to partially deflate. bronchopleural fistula occurs if communication between airways and pleural space remains open

19
Q

what are the features of pneumothorax?

A

sudden onset of unilateral pleuritic pain or progressively increasing breathlessness.
if pneumothorax enlarges, the patient becomes more breathless and may develop pallor and tachycardia
few physical signs if pneumothorax is small
a third of patients have recurrence

20
Q

what are the signs and symptoms of pneumothorax?

A 
P-THORAX
Pleuritic pain
Trachea deviation
Hyper resonance
Onset sudden
Reduced breath sounds (and dyspnea)
Absent fremitus
X-ray showing collapse
21
Q

what is the presentation of a tension pneumothorax?

A

distended neck veins
tracheal deviation
cardiac arrest
death

22
Q

what is the difference between primary spontaneous and secondary spontaneous pneumothorax?

A

primary - pleuritic chest pain, dyspnoea mild or moderate

secondary - no pleuritic chest pain, dyspnoea usually severe

23
Q

what is a primary spontaneous pneumothorax?

A

occurs in patient with no known underlying lung disease
tall and thin people
familial component
associations to marfan syndrome. ehlers-danlos syndrome, alpha-1-antitrypsin deficiency, homocystinuria

24
Q

what is a secondary pneumothorax

A

when the underlying lung is abnormal

25
Q

what diseases can lead to secondary pneumothorax?

A
  • cystic lung disease, emphysema, asthma, pneumocystis jiroveci pneumonia, end stage ILD,
  • parenchymal necrosis, lung abscess, necrotic pneumonia, septic emboli, fungal disease, TB, cavitating neoplasm, radiation necrosis, pulmonary infarct
26
Q

what is usually seen on CXR in a patient with a pneumothorax?`

A
  • visible visceral pleural edge (very thin sharp white line)
  • no lung markings are seen peripheral to this line
  • peripheral space is radiolucent compared to the adjacent lung
  • lung may completely collapse
  • no mediastinum shift unless tension pneumothorax
  • subcutaneous emphysema and pneumomediastinum
27
Q

What is a small pneumothorax?

A

small rim of air
best seen on expiratory X-ray
<20% of radiographic volume

28
Q

what is a medium pneumothorax?

A

definite 20-50% of radiographic volume

29
Q

what is a large pneumothorax?

A

obvious >50% of radiographic volume

some shift of trachea and mediastinum

30
Q

what is tension pneumothorax?

A

lung grossly deflated

marked deviation of trachea and mediastinum

31
Q

what is recurrent pneumothorax?

A

recurs more than twice (1 in 5 recur in first year)

32
Q

what is the management of small pneumothorax?

A

minimal symptoms
resume normal activity but avoid strenuous exercise
observe at 2 weekly intervals until air is reabsorbed

33
Q

what is the initial management of medium, large and tension pneumothorax?

A

aspirate air (if no recurrence follow management of small pneumothorax)

34
Q

what is the management for medium, large and tension pneumothorax if there is a recurrence following aspiration?

A

insert intercostal drainage with underwater seal for 2-3 days.
NEXT
-re-expansion / tube not bubbling=remove tube and re-Xray to exclude recurrence
OR
-pneumothorax remains/tube bubbling = surgery VATS

35
Q

what is the management for recurrent pneumothorax?

A

surgery VATS

36
Q

describe the options for surgery VATS for patients with pneumothorax?

A
  • pleurectomy (no recurrence)

- talc pleurodesis (some recurrence)

Block 31 Cardio-respiratory (15 decks)

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