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Respiratory System > Pleural Diseases > Flashcards

Pleural Diseases Flashcards

1
Q

What is pleura

A

It’s a serous membrane that covers the lung parenchyma, mediastinum, and diaphragm

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2
Q

What are the parts of the pleura

A

-cervical
-costal part
-mediastinal
-diaphragm

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3
Q

What is pneumothorax

A

-collection of air inside the plural cavity

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4
Q

What are the types of pneumothorax

A

-spontaneous
-acquired

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5
Q

What is the classification of spontaneous pneumothorax

A

-primary
-secondary

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6
Q

What is the cause of primary spontaneous pneumothorax

A

-rupture of the bleb in thin, tall, young patient

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7
Q

What is the cause of secondary spontaneous pneumothorax

A

-underlying pulmonary causes (COPD, asthma and cystic fibrosis)
-immunocompromised patients

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8
Q

What is the classification of acquired pneumothorax

A

-traumatic penetration
-iatrogenic (biopsy, CV catheter, thoracentesis)
-barotrauma

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9
Q

What are the risk factors of primary spontaneous pneumothorax

A

-male
-young age (15-30)
-tall and thin
-smoking

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10
Q

What is the side of rupture of bleb in primary spontaneous pneumothorax

A

-apex of upper lobe
-superior segment of lower lobe

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11
Q

What are the symptoms of primary spontaneous pneumothorax

A

-sudden onset of dyspnea
-pleuritic chest pain

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12
Q

What are the signs of primary spontaneous pneumothorax

A

-inspection: decrease of the chest movement
-palpation: <TVF
-percussion: hyperressorance
-auscultation: diminished breath sound

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13
Q

What is the indications of tube thoracotomy

A

-symptomatic PSP
-SSP
-tension pneumothorax

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14
Q

What is the indications of surgical in PSP

A

-recurrent pneumothorax
-massive air leak
-decrease lung expansion after tube thoracotomy

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15
Q

What is the definition of haemothorax

A

-blood in the plural cavity

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16
Q

What is the cause of haemothorax

A

-traumatic penetration
-iatrogenic (biopsy, CV catheter, thoracentesis)

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17
Q

What is the symptoms of haemothorax

A

-cough
-chest pain
-dyspnea

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18
Q

What is the signs of haemothorax in small amount

A

-normal physical examination

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19
Q

What is the signs of haemothorax in large amount

A

-inspection: decrease of the chest movement
-palpation: <TVF
-percussion: dullness
-auscultation: diminished breath sound

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20
Q

What is the X-ray findings of haemothorax in small amount

A

-obliteration of the costophrenic angle

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21
Q

What is the X-ray findings of haemothorax in large amount

A

-homogeneous opacity in obliteration of the costophrenic angel rising to the axilla

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22
Q

What is the X-ray findings of haemothorax if air fluid level is presence

A

-haemopneumothorax

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23
Q

What is the management of haemothorax

A

-restoration of blood volume
-decompression of the lungs by tube thoracotomy

24
Q

What is the indication of tube thoracotomy in haemothorax

A

-persistent haemothorax (3-5)
-massive haemothorax (15)
-clotted pneumothorax

25
Q

What is thoracic empyema

A

-pus in the pleural cavity

26
Q

What is chronic empyema

A

-failure of chest expansion after drainage of the lung

27
Q

What is the causative agents in empyema

A

-specific: TB
-non specific: anaerobes

28
Q

What is the most common source of empyema in children

A

-pnemonia

29
Q

What are the stages of parapneumonic plueral effusion

A

-exudative
-fibropurulent
-organising

30
Q

What is character of exudative stage in parapneumonic plueral effusion

A

-increase fluid due to inflammation

31
Q

What is character of fibropurulent stage in parapneumonic plueral effusion

A

-fibrin deposition leads to loculations
-infected fluid becomes thick and purulent

32
Q

What is character of organising stage in parapneumonic plueral effusion

A

-firm granuloma formation

33
Q

Rest for Question; Take note that the diagnosis of haemothorax is the same with empyema in case of symptoms, signs and x-ray but it has extra which is

A

Thoracentesis

34
Q

During thoracentesis, foul smelling indicates

A

anaerobic

35
Q

What are the criteria of thoracic empyema

A

-pus frank
-based on light criteria

36
Q

List of light criteria based on:
-ph
-glucose
-ldh
-protein level
-WBC

A

-ph<7.2
-glucose<40
-ldh>1000
-protein level>3
-WBC>15000

37
Q

What are the management of the empyema

A

-antibiotic therapy
-chest tube
-thoracoscopy
-rib resection
-decortication
-pulmonary resection
-thoracoplasty

38
Q

What is given during the antibiotic therapy of empyema

A

-broad spectrum antibiotic

39
Q

When is the early insertion of the chest tube in empyema

A

-before loculation of pleural effusion

40
Q

When is the position of the chest tube in empyema

A

-based on the affected site

41
Q

When is the recommended size of bore of the chest tube in empyema

A

large (34-40F)

42
Q

What is the indication of thoracoscopy

A

-multiloculated empyema

43
Q

What is the indication of rib resection

A

-ill patient that cannot tolerate to décortication

44
Q

What are done during decortication of empyema

A

-removal of fibrous peels in visceral pluera
-opening fissures
-removal of thickened parietal pluera

45
Q

what is the indication of pulmonary resection

A

-destruction of the lobes or the whole lungs

46
Q

Combination of thoracoplasty and pedicle flap is used in case of what condition and why

A

-chronic empyema
-due bronchopleural fistula

47
Q

What is pleural mesothelioma

A

-it’s cancer caused by prolonged exposure of asbestos

48
Q

What is the most common type of mesethelioma

A

-pleural mesothelioma

49
Q

What is the histological type of pleural mesothelioma

A

-epithelial
-sarcomatous
-mixed

50
Q

What is the median survival rate of pleural mesothelioma

A

12-18

51
Q

What is the treatment pleural mesothelioma

A

-surgical, chemotherapy, radiotherapy
-pleurodesis (gives relief)

52
Q

What is chylothorax

A

-lymph in the pleura cavity

53
Q

What is the cause of chylothorax

A

-congenital
-neoplasm as lymphoma

54
Q

What is the investigation of chylothorax

A

-same with haemothorax
-aspiration; TGA:Cholesterol>1

55
Q

What is the treatment of chylothorax

A

-chest tube
-right thoracotomy (ligation of thoracic duct)
-video surgery

56
Q

What is the indication of right thoracotomy (ligation of thoracic duct) in chylothorax

A

-drainage >1500 per 5 days

Respiratory System (15 decks)

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