Pleural effusion, pneumothorax and mesothelioma

Question 1

What criteria is used to distinguish a transudate from an exudate?

Answer 1

LIGHTS criteria

Question 2

What is the gold standard procedure for obtaining a pleural biopsy?

Answer 2

VATS (video-assisted thoracoscopy)

Question 3

Give 3 causes of an exudate

Answer 3

malignancy (mesothelioma), infection (pneumonia), trauma, auto-immune conditions (SLE, RA)

Question 4

Give 3 causes of a transudate

Answer 4

Liver cirrhosis (reduced albumin), nephrotic syndrome (albumin loss), heart failure, renal failure, hypoalbuminaemia

Question 5

What has a higher protein and LDH content: transudate or exudate?

Answer 5

Exudate

Question 6

Why is there

Answer 6

Glucose is a bacterial substrate

Question 7

Give a genetic condition that predisposes to pneumothorax

Answer 7

Marfan’s syndrome

Question 8

How does tension pneumothorax differ from a normal pneumothorax?

Answer 8

There is peural tear acting as a ‘one way valve’ so there is NO equalisation of pressure > pressure continues to build up displacing mediastinal organs > cardiorespiratory arrest

Question 9

What is the characteristic symptom and symptom of pneumothorax?

Answer 9

symptom: Unilateral pleuritic chest pain
sign: hyper-resonant percussion

Question 10

What is the characteristic sign of tension pneumothorax?

Answer 10

Deviated trachea

Question 11

What is the treatment for tension pneumothorax?

Answer 11

Emergency needle decompression and then drainage