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1st Year - Clinical Respiratory > Pleural Disease > Flashcards

Pleural Disease Flashcards

1
Q

What is a Pleural Effusion

A

A build up of excess fluid between the layers of the pleura outside the lung (often basally)

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2
Q

What are some causes of Pleural Effusions (x5)

A 
Leaking from other organs 
Lung cancer
Infections (pneumonia/TB) 
Autoimmune conditions 
Pulmonary embolism
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3
Q

What are symptoms of a pleural effusion

A

S.O.B
Pleuritic pain
Fever
Cough

BUT COULD BE NO SYMPTOMS

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4
Q

What tests can be used to check for pleural effusion

A

X-ray
CT scan
Ultrasound

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5
Q

What will an X-ray with pleural effusion show

A

Loss of Costo-phrenic angle
Concave or horizontal fluid level
Tracheal deviation
Opacity

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6
Q

What does Straw coloured pleural fluid indicate

A

Normal

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7
Q

What does Cloudy coloured pleural fluid suggest

A

Exudate it present, suggesting infection

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8
Q

What does Blood in the pleural fluid suggest

A

Malignancy
Tuberculosis
Trauma
Myocardial Infarction

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9
Q

What does pus in the pleural fluid suggest

A

Empyema

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10
Q

What is Empyema

A

Empyema is defined as a collection of pus in the pleural cavity, gram-positive, or culture from the pleural fluid. Empyema is usually associated with pneumonia but may also develop after thoracic surgery or thoracic trauma.

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11
Q

What two categories can Pleural effusions be split into

A

Transudative

Exudative

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12
Q

What are features of transudative pleural effusions

A

The fluid present is similar to normal pleural fluid as it forms from liquid leaking across the normal pleura.
Usually doesn’t need to be drained
Caused by organ failure

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13
Q

Whats the most common cause of transudative pleural effusions

A

Congestive Heart failure

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14
Q

What are features of Exudative pleural effusions

A

The fluid forms from extra liquid, blood, protein etc that leak across damaged blood vessels into the pleural cavity
May need to be drained

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15
Q

What the most common causes of exudative pleural effusions

A

Pneumonia

Lung cancer

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16
Q

What can be done to directly treat the pleural effusion

A

Tube Thoracotomy

17
Q

When should you do a Tube Thoracotomy

A 
If pleural effusion is large
If patient is/has:
- breathless
-Tachycardic 
- Increased respiratory rate 
-Hypoxic 
-Deviated trachea
18
Q

What should you do if the pleural effusion keeps returning after treatment

A

Consider using a long term catheter in pleural space which can drain pleural effusion at home

19
Q

What is an exudative effusion associated with pneumonia called

A

A parapneumonic effusion

20
Q

When should you drain a parapneumonic effusion

A

If pH<7.2

21
Q

What is a Pneumothorax

A

A pneumothorax is a collapsed lung. Its occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse

22
Q

How can you categorise Pneumothorax

A

Spontaneous (primary and secondary)
Traumatic (Iatrogenic and Non-Iatrogenic)
Tension

23
Q

What are features of a primary spontaneous pneumothorax

A

No pre-existing lung disease
Usually men aged 15-30
Tall thin cannabis smokers
A small air bubble on the lung ruptures

24
Q

What are features of a Secondary spontaneous pneumothorax

A

Arise from lung disease (injury to the pleura)
Usually men aged >55
High recurrence rate

25
Q

How to you manage a pneumothorax

A

Depending on Patient History, the size of the pneumothorax, the breathlessness of the patient, either:

Aspirate
Discharge them
Chest drain
Admit to hospital

26
Q

What is a tension pneumothorax

A

A large pneumothorax that causes cardiorespiratory compromise

27
Q

What can you do if the pneumothorax is not resolving

A

Send home with chest drain
Medical pleurodesis
Cardiothoracic referral

28
Q

What is Medical pleurodesis

A

Pleurodesis is a medical procedure in which the pleural space is artificially obliterated. It involves the adhesion of the two pleurae.

29
Q

What are the clinical signs of a tension pneumothorax

A 
Patient distressed 
Trachea deviated
Subcutaneous emphysema 
Reduced chest expansion 
Hyper resonance 
Tachycardia
30
Q

What should you do if patient has a tension pneumothorax

A

EMERGENCY
Give oxygen
Aspirate in the 2nd intercostal space in the mid clavicular line and insert chest drain
Chest Xray and Ultra sound - post drain

31
Q

What are the main cause of transudative pleural effusion

A 
Congestive heart failure
renal/liver failure 
Hypoalbumineuria 
Meigs syndrome
Hypothyroidism
32
Q

What is meigs syndrome

A

right sided pleural effusion with ovarian malignancy

1st Year - Clinical Respiratory (11 decks)

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