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Clin Med 1 - Exam 2 > Pleural Effusion and Tube Thorascopy > Flashcards

Pleural Effusion and Tube Thorascopy Flashcards

1
Q

Which type of pneumothorax needs urgent treatment with a large bore needle in 2nd ICS + chest tube?

A

Tension pneumothorax

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2
Q

Most common cause of pneumothorax

A

Iatrogenic (traumatic)

-Invasive procedures (central line, throacentesis)
-Mechanical ventilation
-CPR

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3
Q

What is the most important respiratory muscle?

A

The diaphragm!

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4
Q

What are the cornerstones of treatment for parapneumonic/empyema pleural effusions?

A

Antibiotics and drainage

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5
Q

Pleural fluid analysis with Hct >50% venous blood suggests what condition?

A

Hemothorax

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6
Q

Which, primary or secondary spontaneous pneumothorax, is more symptomatic?

A

Secondary

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7
Q

Which, transudative or exudative serous fluid in the pleural space, is mostly caused by increased hydrostatic and oncotic pressures?

A

Transudative

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8
Q

Tube thoracostomy is best used in patients with these types of pleural effusions

A

Complicated parapneumonic/empyema

Pneumothorax

Hemothorax

Malignant effusion

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9
Q

Which nerves innervate the diaphragm?

A

C3, C4, C5

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10
Q

Best imaging for mediastinal tumors

A

CT most common

Barium swallow for obstructions

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11
Q

Best diagnostic tool for pleural plaques?

A

CT scan

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12
Q

Which, primary or secondary spontaneous pneumothorax, is more common in tall, thin, smoking males?

A

Primary

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13
Q

Abnormal accumulation of fluid in the pleural space is most often caused by this force

A

Increased hydrostatic pressure

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14
Q

Which cause of pleural effusion can have transudative and exudative serous fluid

A

Pulmonary embolism

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15
Q

Symptoms associated with secondary spontaneous pneumothroax

A

Chest pain, dyspnea, low BP, cyanosis, death

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16
Q

Best imaging tool to assess shape of diaphragm?

A

Chest x-ray

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17
Q

Which, primary or secondary spontaneous pneumothorax, has a high recurrence rate of 50% > 62% > 83%?

A

Primary

18
Q

Which, primary or secondary spontaneous pneumothorax, is associated with rupture of subpleural blebs?

A

Primary

19
Q

Best diagnostic tool for pleural effusions

A

Thoracentesis

20
Q

Transudative serous fluid in both sides of the pleural space is most commonly caused by what disease?

A

CHF

21
Q

Physical exam signs for pleural effusion

A

Dull percussion

Decreased breath sounds

Decreased fremitus/egophony

22
Q

Which, transudative or exudative serous fluid, has lower protein and LDH levels?

A

Transudative

23
Q

Define pneumothorax

A

Presence of air in the pleural space

24
Q

How will a diaphragm present on chest x-ray in cases of diaphragmatic paralysis?

A

Elevated on side of paralysis

25
Q

Most common cause of diaphragmatic paralysis

A

Malignancy - bronchogenic cancer

26
Q

Which type of pleural effusion will have high (>10k) white blood cell levels on a cell count/differential?

A

Parapneumonic with empyema

27
Q

What substances are used to obliterate pleural space?

A

Pleural sclerosants

28
Q

Which pneumothorax presents with a tracheal shift?

A

Tension pneumothorax

Emergency!

29
Q

In which type of pleural effusion is thoracentesis unneccessary?

A

CHF with bilateral and equal effusion

30
Q

Most common disease causes of pleural effusion

A

CHF the most common

Also malignancy, pneumonia, PE

31
Q

Apart from COPD, what other conditions can cause diaphragmatic dysfunction?

A

Myopathies: polymyocitis, MD, MS, ALS, hypothyroidism

32
Q

How will a diaphragm present on chest x-ray in cases of hyperinflated lungs?

A

Flattened diaphragm

33
Q

Causes of secondary spontaneous pneumothorax

A

COPD

TB

Pneumocystis pneumonia

Fibrosis

Carcinoma

34
Q

Which imaging technique is used to assess paradoxical motion of the diaphragm?

A

Fluoroscopy

35
Q

Which type of pleural effusion typically presents with symptoms of fever, chest pain, cough, and dyspnea

A

Parapneumonic effusion with empyema

36
Q

Increased triglyceride levels in pleural fluid analysis suggests what type of effusion?

A

Chylous effusion

37
Q

When to not use pleural sclerosants?

A

In cases of trapped lung

38
Q

Which, transudative or exudative serous fluid in the pleural space, is mostly caused by pleural capillary/venule membrane breakdown or lymph obstruction?

A

Exudative (result of increased permeability)

39
Q

Which, transudative or exudative serous fluid, has higher protein and LDH levels?

A

Exudative

40
Q

True or false. Mediastinal tumors are more malignant in adults than children.

A

False

Children - 45%
Adults - 25%

41
Q

Best treatment for diaphragmatic disorders?

A

Treat underlying condition

Clin Med 1 - Exam 2 (5 decks)

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