Pleural Diseases Flashcards
What is pleural effusion and how is it classified?
Pleural effusion is the accumulation of fluid in the pleural cavity. It is classified into: - Exudative: High protein content (caused by infections, malignancies) - Transudative: Low protein content (caused by conditions like heart failure, liver failure) Diagnosis often uses Light’s criteria to differentiate between the two types.
What are the potential long-term outcomes for patients with recurrent pleural disease?
Potential long-term outcomes for patients with recurrent pleural disease may include: - Chronic respiratory issues - Reduced lung function - Increased risk of infections - Development of pleural fibrosis - Potential for malignancy in cases of pleural malignancy
What diagnostic tests are used to identify a pneumothorax?
Diagnostic tests for pneumothorax include: - Chest X-ray: to visualize air in the pleural space - CT scan: for detailed imaging - Ultrasound: to assess pleural effusion or pneumothorax - Thoracentesis: to analyze pleural fluid if needed - Spirometry: to evaluate lung function and underlying conditions
What are some common causes of transudative pleural effusion?
Common causes of transudative pleural effusion include: - Heart failure - Liver failure - Renal failure - Hypoalbuminemia
How can pneumothorax be differentiated from tension pneumothorax?
Pneumothorax vs. Tension Pneumothorax: - Pneumothorax: Air in pleural space, may be asymptomatic or mild symptoms. - Tension Pneumothorax: Increased pressure, severe respiratory distress, hypotension, and mediastinal shift. Requires immediate needle thoracentesis.
What symptoms might suggest the presence of pleural malignancy?
Symptoms suggesting pleural malignancy include: - Pleuritic chest pain - Dyspnea - Cough - General symptoms of malignancy (e.g., weight loss, fatigue)
What procedures may be indicated for complicated parapneumonic effusions?
For complicated parapneumonic effusions, indicated procedures include: - Drainage (e.g., chest tube) - Video-Assisted Thoracoscopic Surgery (VATS) - Talc pleurodesis - VATS decortication for empyema These help manage symptoms and prevent complications.
What role does thoracentesis play in diagnosing pleural effusion?
Thoracentesis helps diagnose pleural effusion by: - Removing fluid for analysis - Assessing fluid characteristics (exudate vs. transudate) - Identifying infections, malignancies, or other underlying conditions through cytology and biochemical tests.
What complications can arise from untreated pneumothorax or pleural effusion?
Complications from untreated pneumothorax or pleural effusion can include: - Tension pneumothorax - Cardiac tamponade - Respiratory or cardiac arrest - Pneumomediastinum - Recurrent disease - Empyema - Sepsis
How does smoking influence the risk of developing pleural diseases?
Smoking significantly increases the risk of developing pleural diseases by introducing carcinogens that can lead to lung cancer and other respiratory issues. It contributes to conditions like pneumothorax and pleural effusion, and passive smoking also raises risks for non-smokers.
What is the primary function of the respiratory system?
The primary function of the respiratory system is to facilitate gas exchange. It brings oxygen into the body and removes carbon dioxide, supporting cellular respiration and maintaining blood pH levels.
What are the differences between transudative and exudative pleural effusions?
Transudative Pleural Effusions: - Low protein content - Caused by systemic issues (e.g., heart failure, liver failure) Exudative Pleural Effusions: - High protein content - Caused by local factors (e.g., infections, malignancy) Key Test: Light’s criteria helps differentiate between the two types.
What are the signs that may indicate tension pneumothorax during physical examination?
Signs indicating tension pneumothorax: - Respiratory distress - Tachypnea - Decreased breath sounds on affected side - Hyper-resonant percussion note - Tracheal deviation away from affected side - Raised JVP - Low blood pressure (hemodynamic compromise)
What underlying conditions can lead to secondary pneumothorax?
Underlying conditions leading to secondary pneumothorax include: - Chronic lung diseases (e.g., COPD, asthma, cystic fibrosis) - Pneumonia - Malignancy (primary or secondary) - Tuberculosis (TB) - Connective tissue disorders (e.g., Marfan’s syndrome) - Trauma or mechanical ventilation
How does clubbing relate to pleural disease diagnosis?
Clubbing is often associated with malignancy and can indicate underlying pleural disease. It may suggest chronic hypoxia or lung pathology, helping to guide diagnosis and further investigations in patients with pleural conditions.
What physical examination findings are indicative of pneumothorax?
Physical examination findings indicative of pneumothorax include: - Decreased breath sounds - Hyper-resonant percussion note - Tracheal deviation (if tension pneumothorax) - Respiratory distress - Tachypnea - Palpable subcutaneous emphysema (if present)
How can you assess if a chest drain is functioning properly?
To assess if a chest drain is functioning properly: - Check for oscillation with breathing - Look for bubbling (indicates pneumothorax) - Ensure it is not clamped - If no oscillation or bubbling, the drain may be blocked or the pneumothorax resolved.
What role does oxygen supplementation play in managing pneumothorax?
Oxygen supplementation in pneumothorax management helps: - Increase the absorption of air in the pleural space - Improve oxygenation - Reduce the size of the pneumothorax It’s typically administered via a non-rebreather mask, except in COPD cases where oxygen must be carefully prescribed.
What are the typical management principles for patients with pneumothorax?
Typical management principles for pneumothorax include: - Administer oxygen via non-rebreather mask - For tension pneumothorax: perform needle thoracentesis - For secondary pneumothorax >2cm or symptomatic: insert chest drain - Monitor and repeat imaging for resolution - Consider pleurodesis if unresolved after 3 days or persistent air leak
What are the common causes of pleural effusion that require specific treatments?
Common causes of pleural effusion requiring specific treatments include: - Exudative effusions: - Pneumonia - Malignancy (primary or secondary) - Tuberculosis - Asbestos exposure - Transudative effusions: - Heart failure - Liver failure - Renal failure - Hypoalbuminemia
What are the indications for inserting a chest drain in cases of pneumothorax?
Indications for inserting a chest drain in pneumothorax include: - Secondary pneumothorax >2 cm or symptomatic - Persistent air leak - Pneumothorax not resolving after 3 days - Recurrence of pneumothorax
What investigations are typically conducted for a patient suspected of having pneumothorax?
Investigations for suspected pneumothorax typically include: - Chest X-ray: to confirm presence and size - CT scan: for detailed imaging - FBC: to assess infection and platelets - Coagulation tests: PT/INR, aPTT - Thoracentesis: for fluid analysis if needed - Spirometry: to check for underlying lung conditions
How does the management of pleural effusion differ based on its underlying cause?
Management of pleural effusion varies by cause: - Infectious (e.g., pneumonia, TB): Antibiotics - Malignancy: Treat cancer, consider drainage - Heart failure: Diuretics - Liver/Renal failure: Manage underlying condition - Complicated effusions: Drainage (e.g., chest tube, VATS)
What are the common symptoms associated with pleural effusion?
Common symptoms of pleural effusion include: - Pleuritic chest pain - Dyspnea (shortness of breath) - Cough - Symptoms related to the underlying cause (e.g., infection, malignancy)
