Pleural disorder

Question 1

what is pleurisy

Answer 1

inflammation of the pleural usually due to underlying lung process

Question 2

what cause pleurisy

Answer 2

pneumonia 
URTI
infarction
TB
parietal pleural injury

Question 3

what is the treatment for pleurisy

Answer 3

NSAIDS, codeine

Question 4

what is transudative effusion

Answer 4

Caused by fluid leaking into the pleural space.

most common & usually bilateral (R side > L side)

Question 5

what causes transudative effusion

Answer 5

increase BP (CHF),

decrease in oncotic pressure in capillaries
due to (liver & kidney disorders leading to hypoproteinemia)

This is from increased pressure in the blood vessels or a low blood protein count.

imbalance between hydrostatic & oncotic pressure in pulmonary capillaries

Question 6

What are 2 types of CHF that cause transudate effusion?

Answer 6

RT side heart failure

Left side heart failure:

Question 7

Mechanism of RT side heart failure

Answer 7

increase hydrostatic pressure in systemic circulation

decrease lymphatic drainage from pleural space

increase rate of pleural fluid formation

backpressure will increase the hydrostatic pressure in the pulmonary capillaries

Question 8

mechanism of left side heart failure

Answer 8

increase hydrostatic pressure in pulmonary circulation

cause fluid movement through the visceral pleura

Question 9

what is Exudative effusion

Answer 9

effusion due to changes in capillary permeability

Question 10

what causes Exudative effusion

Answer 10

inflammation
infection or malignancy
trauma
surgery
cancer, infection, TB, systemic disease like lupus, intra-abdominal disease

Question 11

what are Exudate properties

Answer 11

fluid has high protein count with lots of cellular debris & high specific gravity (thick/purulent)
significant increase WBC
low glucose

Question 12

what are Transudate properties

Answer 12

thin, watery and contains a few blood cells, low protein count and low specific gravity (density)

Question 13

what is empyema

Answer 13

infected pleural effusion

Question 14

cause of empyema

Answer 14

bacteria due to rupture of lung abscess, pneumonia, penetrating wound

Question 15

treatment for empyema

Answer 15

chest drainage, antibiotics

Question 16

what is hemothroax

Answer 16

bloody pleural effusion

caused by Trauma, burst vessel (P.A. or Aorta)

Question 17

what is fibrothorax

Answer 17

fibrosis of the pleural membranes

Post inflammation or asbestos

Question 18

what is Chylothorax

Answer 18

an accumulation of lymphatic fluid in the pleura

–> milky white appearance and contains fat and lymph

Question 19

Wht cause chylothorax

Answer 19

traumatic injury to neck

tumour invasion of thoracic duct

Question 20

outcome of pleural effusion

Answer 20

Restrictive Disorder

Atelectasis

Compression of great vessels

Question 21

clinical manifestation of pleural effusion

Answer 21

dyspnea
tachypnea
orthopnea
dull percussion 
fine crackles

Question 22

cxray diagnosis of pleural effusion

Answer 22

blunting of costrophrenic angles
Congested lymphatic
Homogenous density

use lateral decubitus to detect small effusion

Question 23

what is the ph of empyema

Answer 23

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