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Respiratory > Pleural Diseases > Flashcards

Pleural Diseases Flashcards

1
Q

What does the parietal pleura cover?

A

Rib cage
Mediastinum
Diaphragm

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2
Q

What pulls the the visceral pleura inward?

A

Lungs elastic recoil

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3
Q

What pulls the parietal pleura outward?

A

Chest wall

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4
Q

Which way does the fluid flow in the pleural space? How much flows through here?

A

From the parietal pleura to the pleural space

5-10L

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5
Q

What are the two types of pleural effusions?

A

Transudative

Exudative

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6
Q

What are the two types of pneumothorax?

A

Spontaneous

Traumatic

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7
Q

What are the symptoms of a pleural effusion?

A

Cough
SOB
Pleuritic chest pain

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8
Q

What are the signs of a pleural effusion?

A

Hypoxia
Tachypnea
Dullness to percussion

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9
Q

What type of breath sounds are predominant with a pleural effusion?

A

Bronchial

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10
Q

What happens to the mediastinum with a pleural effusion?

A

Shifts away from the lung

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11
Q

What are the CXR findings of a pleural effusion?

A
  • Dense lung opacification
  • Blunting of the costophrenic angle
  • Lung shifted upward
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12
Q

What is the best position for the patient to be in to detect a pleural effusion?

A

Left lateral decubitus

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13
Q

How helpful is a gross examination of pleural fluid?

A

Rarely helpful unless bloody or chylous

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14
Q

Why are pleural effusions smelly?

A

Anaerobic infections

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15
Q

What is examined with a thoracentesis?

A
  • WBC
  • pH
  • Glucose
  • Protein
  • LDH
  • Cultures
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16
Q

What is the pleural fluid/serum protein level for exudate?

A

Greater than 0.5

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17
Q

What is the pleural fluid/serum LDH level for exudate?

A

Greater than 0.6

18
Q

What are the causes of transudate? (4)

A

CHF
PE
Cirrhosis
Nephrotic syndrome

(anything that decreases oncotic pressure, or increases hydrostatic pressure)

19
Q

What are the causes of exudate? (4)

A

Tumor
Infection
Trauma
Inflammation

20
Q

What is the pleural fluid analysis reveal for a pleural fluid?

A

pH less than 7.2

21
Q

What can cause an increase in amylase in pleural fluid?

A

Pancreatitis

Esophageal rupture

22
Q

What is the treatment for an empyema with a low pH (less than 7.2)?

A

Chest tube

23
Q

What does a decreased glucose level in pleural fluid indicate?

A

Infection or neoplasm

24
Q

What is a cholesterol effusion?

A

Presence of cholesterol crystals in pleural fluid caused by long standing chronic pleural effusions

25
Q

What usually causes a chylothorax?

A

Milky effusion that has high lipid content, usually caused by trauma or neoplastic process

26
Q

What is the pleural fluid HCT/Serum HCT of a hemothorax?

A

Greater than 0.5

27
Q

What is chemical pleurodesis?

A

Administration of a sclerosing agent, irritant into the pleural space

28
Q

What is the indication for a chemical pleurodesis?

A

Recurrent pleural effusions which initially responded to simple thoracentesis

29
Q

What is usually used to a chemical pleurodesis?

A

Talc powder

Doxycycline

30
Q

What is the indication for a pleural biopsy?

A

Persistent pleural effusions, especially when TB is suspected

31
Q

What are the ssx of a pneumothorax?

A

SOB
Chest pain
Cough

32
Q

What happens to the mediastinum with a pneumothorax?

A

Shifts toward unless tension, then away

33
Q

When is a thoracostomy tube indicated for a pneumothorax?

A

Greater than 50%

34
Q

What are the causes of pneumothorax?

A
  • Emphysema
  • ILD
  • Eosinophilic granuloma
  • CF
  • Asthma
  • Malignancy
35
Q

What type of workup should be done in a patient with a new onset pneumothorax, without explainable cause?

A

Malignancy

36
Q

What are the idiopathic causes of a pneumothorax?

A
  • esophageal perforation

- Mechanical ventilation

37
Q

What is mesothelioma?

A

Benign or malignant growths in the plural space d/t asbestos exposure

38
Q

What are the common tumors that invade the pleural space?

A

Bronchogenic or carcinoma

39
Q

What is type of pleural effusion is seen with malignancy?

A

Blood

40
Q

What are the drugs that can cause SLE induced pleural disease?

A

INH
Procainamide
Hydralazine

41
Q

What type of virus can cause pleural disease?

A

Coxsackie

Respiratory (34 decks)

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