Pleural Diseases Flashcards
What are the Clinical Presentations of a Pleural Effusion?
Cough
Dyspnia
Nonspecific Discomfort
Occasional Pleuritic Chest pain
What are the physical findings of a pleural effusion?
Hypoxia Tachypnia Dullness on percussion Decreased Breath Sounds Bronchial Breathing Mediastinal Shift
What are the steps of evaluation of pleural fluid?
Gross visual exam Olfactory exam Serologic Exam Send out for WBC w/differential Cell count Glucose Protein LDH Cultures/Gram stain Amylase Cytology
What are the parameters of a Transudate?
Pleural fluid protein/serum protein
What are the parameters of a Exudate?
Pleural fluid protein/serum protein >0.5
Pleural fluid LDH/Serum LDH >0.6
Pleural fluid LDH >0.45 normal serum
What are Causes of Transudates vs exudates
Trans: Hydrostatic or osmotic pressure; CHF, PE, cirrhosis, nephrotic synd, hypoalbuminemia
Exudates: Protein Rich; Tumor, infection, trauma, inflammatory conditions.
What is an empyema?
***pH
What are other factors in Analysis of pleural fluid?
Amylase Decreased glucose? Cholesterol effusion Chylothorax Hemothorax
What is Chemical Pleurodesis?
Administration of a sclerosing agent or irritant to “glue” the lung to the pleural wall.
What are the treatment options in pneumothorax?
Nothing(wait and watch)
Drainage by tube thoracostomy.
(may need to maintain suction for days!)
What is the tumor/cancer associated with the pleural space?
Mesothelioma associated with Asbestos exposure
Can be benign or aggressive or malignant
What are common causes of spontaneous Pneumothorax?
Iodiopathic Emphysema Interstitial Lung disease Eosinophilic granuloma/ histeocytosis X Cystic Fibrosis Asthma Malignancy
What are common causes of Traumatic Pneumothorax?
Penetrating and non-penetrating chest trauma
Transbronchoscopic or transthoracic lung biopsy
thoracentesis
Mechanical ventilation
Esophageal perforation
