Brainscape's Knowledge GenomeTM

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


See full index

Respiratory System - exam style qs > Pleural disease - pleural effusion, pneumothorax, mesothelioma > Flashcards

Pleural disease - pleural effusion, pneumothorax, mesothelioma Flashcards

1
Q

Describe the pleura

A

Single layer of mesothelial cells with sub-pleural connective tissue
Two layers: visceral and parietal
Pleural cavity inbetween with negative pressure and 2-3ml pleural fluid

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

What is a pleural effusion?

A

abnormal collection of fluid in the pleural space

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

Symptoms of pleural effusion

A 
Asymptomatic
Breathlessness
Pleuritic chest pain
Dull ache
Dry cough
Weigh loss, malaise, fevers, night sweats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs of pleural effusion

A 
On affected side:
reduced expansion
stony dullness to percussion
reduced breath sounds
reduced vocal resonance
clubbing, tar staining
cervical lymphadenopathy
raised JVP
trachea away from large effusion
peripheral oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two classifications of effusion?

A

transudates and exudates

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

Pathophysiology of transudate effusion

A

an imbalance of hydostatic forces influencing the formation and absorption of pleural fluid
usually bilateral

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

Pathophysiology of exudate effusion

A

increased permeability of pleural surface and/or local capillaries
usually unilateral

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

Protein content of transudates and exudates?

A

Transudate less than 30g/l

Exudate more than 30g/l

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

Very common causes for transudate effusions?

A

Left ventricular failure
Liver cirrhosis
Hypoalbuminaemia
Peritoneal disease

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

Less common causes for transudate effusion

A

Hypothyroidism
Nephrotic syndrome
Mitral stenosis
Pulmonary embolism

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

Very common causes for exudate effusions

A

Malignancy

Parapneumonic

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

Less common causes for exudate effusions

A 
Pulmonary embolism/infarction
Rheumatoid arthritis
Autoimmune diseases
Benign asbestos effusion
Pancreatitis
Post-myocardial infarction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Investigations (with exudates mainly)

A 
Chest x-ray
Contrast enhanced CT of thorax
Pleural aspiration
Pleural biopsy
Thoracopy/ video assisted thorascopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How much fluid must be in a pleural effusion before it is detectable on a chest x-ray?

A

200ml

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

What might you find in a CT of the thorax?

A 
nodular pleural thickening
mediastinal pleural thickening
parietal pleural thickening > 1cm
Circumferential pleural thickening
other malignant manifestations in the lung/liver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When ‘looking and sniffing’ the sample from a pleural aspiration, what do the following results indicate?

  1. foul smelling
  2. pus
  3. food particles
  4. milky
  5. blood stained
  6. blood
A 
foul smelling - anaerobic empyema
pus - empyema
food particles - oesophageal rupture
milky - chylothorax (lymph)
blood stained - malignancy
blood - haemothorax, trauma
17
Q

Where/ how should a pleural biopsy be done?

A

Immediately above a rib to avoid neurovascular bundle
Cutting edge downwards
Abram’s needle or Tru-cut

18
Q

How many pleural biopsies should be taken?

A

At least 4
3 in formaldehyde for histology
1 in saline to microbiology if TB suspected

19
Q

Management of pleural effusion

A

Treatment directed at the cause: chemotherapy, anti TB drugs, corticosteroids
Pleural aspiration
Pleurodhesis
Surgical pleurodhesis

20
Q

What surface anatomy is used to locate position for a pleurodhesis?

A

4th intercostal space mid-axillary line

21
Q

What is a pneumothorax?

A

Presence of air within the pleural cavity, lung collapses

22
Q

Describe the 4 causes

A

Primary spontaneous - young, thin, tall male (apical blebs rupture)
Secondary spontaneous - underlying lung disease
Traumatic (non-iatrogenic) - car accident, stabbing
Traumatic (iatrogenic) - surgeon/physician makes cut

23
Q

What is it called when there is a progressive build up of air within the pleural space due to a one way valve which eventually pushes the lungs and mediastinum to one side?

A

Tension pneumothorax

24
Q

Symptoms of pneumothorax

A

asymptomatic
acute breathlessness
pleuritic chest pain

25
Q

Signs of non-tension pneumothorax

A 
surgical emphysema (bubble wrap feeling under skin)
trachea deviated to affected side
on affected side:
reduced expansion
hyper resonant
absent or reduced breath sounds
26
Q

Signs of tension pneumothorax

A

trachea deviated away from affected side
haemodynamic compromise
raised JVP

27
Q

Management of tension pneumothorax

A

cannula in 2nd intercostal space mid-clavicular line and chest drain

28
Q

management of small primary pneumothorax

A

observe overnight, repeat chest x-ray
discharge
review in chest clinic in 2 weeks and advise no vigorous activity

29
Q

management of breathless primary/ secondary pneumothorax and worsening

A

aspirate
intercostal chest drain
apply suction
thoracic surgeon at 3 days

30
Q

3 main types of asbestos

A

chrysotile (white)
amosite (brown)
crocidolite (blue)

31
Q

What is mesothelioma?

A

Pleural malignancy, normally due to asbestos

Respiratory System - exam style qs (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions