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SEM 5: SAM 1 > Pleural Effusion, Pneumothorax, and Pneumomediastinum > Flashcards

Pleural Effusion, Pneumothorax, and Pneumomediastinum Flashcards

1
Q

True or False: Pleural effusion results in increased intrathoracic pressure and decreased pulmonary compliance

A

True

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2
Q

Explain the breathing pattern that can be seen with pleural effusion

A

Restrictive - shallow and rapid breaths

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3
Q

What is the most likely cause of a pure transudate pleural effusion?

A

hypoalbuminemia (PLN, PLE, liver failure)

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3
Q

_________ is a more common cause of pyothorax in dogs than cats

A

migrating FB

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4
Q

_________ is a more common cause of pyothorax in cats than dogs

A

bite wounds and extension of bacterial pneumonia

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5
Q

Why are thoracic radiographs prior to thoracocentesis discouraged in a patient with moderate pleural effusion?

A
  1. too must stress
  2. Large amt of fluid is life threatening
  3. Fluid in pleural space will obscure the heart (same opacities).. waste of money + time
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6
Q

List 2 neoplastic causes of pleural effusion

A
  • Mesothelioma
  • Carcinomatosis - diffuse metastatic disease 2ndary to carcinoma
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7
Q

Clinical signs of pleural effusion are usually chronic except if the cause is due to _____________

A

trauma or toxicity

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8
Q

A patient with muffled lung sounds, fever, and dyspnea likely has

A. Protein loosing enteropathy
B. Pericardial effusion
C. Pyothorax
D. R-sided heart failure

A

C. Pyothorax

All can cause pleural effusion, which can cause muffled lung sounds and dyspnea

only pyothorax will cause fever

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9
Q

Which of the following causes of pleural effusion is associated with a rapid diagnosis, treatment, and better outcome compared to the others?

A. Protein loosing enteropathy
B. Pericardial effusion
C. Pyothorax
D. R-sided heart failure

A

C. Pyothorax

one of the few curable underlying causes of pleural effusion

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10
Q

_____________ is a malignant neoplasm originating from serosal surfaces, like the parietal pleura that is attached to the chest wall

A

mesothelioma

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11
Q

What is the prognosis in a patient with secondary pleural effusion from mesothelioma or carcinomatosis?

A

Grave prognosis for both

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11
Q

What is the treatment protocol for a patient presenting with a pyothorax?

A
  • Drain fluid via thoracostomy tubes
  • IV antibiotics (broad spectrum pending C&S)
  • IV fluids
  • Sx if pyothorax is from a penetrating FB (dogs>cats)
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12
Q

What is the treatment protocol for a patient presenting with a chylothorax?

A

usually requires surgical intervention

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12
Q

When is therapeutic thoracocentesis indicated?

A
  • Necessary in patients with mod-severe effusion
  • Relieve dyspnea + remove as much fluid as possible

save samples for diagnosis

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12
Q

When is diagnostic thoracocentesis indicated?

A
  • Performed in any patient with newly diagnosed pleural effusion
  • Collection of fluid helps aid in diagnosis
  • Can submit for culture + sensitivity if suspect infection
  • Can do proBNP of pleural effusion in cats if suspect cardiac cause
12
Q

What is the treatment protocol for a patient presenting with pleural effusion from mesothelioma?

A
  • Intracavitary chemotherapy w Cisplatin/Carboplatin
  • Periodic thoracocentesis or pleural port

(guarded long term prognosis tho)

13
Q

What is the treatment protocol for a patient presenting with pleural effusion secondary to metastatic carcinoma?

A

Same as mesothelioma

  • Intracavitary chemotherapy
  • Periodic thoracocentesis or pleural port

(guarded long term prognosis tho)

14
Q

What is found in a fluid sample from a chylothorax that aids in diagnosis and helps R/O other causes of pleural effusion?

A
  • Small lymphocytes
  • Higher triglycerides in fluid vs in the blood
  • Milky appearance
15
Q

List potential complications of pleural effusion regardless of etiology

A
  1. Fibrosing pleuritis
  2. Lung lobe torsion (able to twist when floating in fluid)
16
Q

True or False: Clinical signs and pulmonary auscultation of pneumothorax is similar to that of pleural effusion

A

true

17
Q

What is tension pneumothorax?

A

volume of air is so significant that it depresses CO - fatal if not treated promptly

18
Q

True or False: Tension pneumothorax is fatal if not treated promptly

A

True

  • depresses CO
19
Q

List the 3 types/etiologies of pneumothorax

A
  1. Traumatic
  2. Spontaneous
  3. Iatrogenic
20
Q

List causes of traumatic pneumothorax

A
  1. Blunt trauma (Hit by car)
  2. Penetrating wound (Bite, fence)
21
Q

What is the prognosis for a patient with pneumothorax from blunt force trauma (Ex: Hit by car)?

A

Blunt trauma pneumothorax usually managed medically & resolves in a few days

22
Q

What is the treatment plan for a patient with pneumothorax from penetrating bite wounds?

A
  • Requires surgical exploration after P is stabilized
23
Q

What is the treatment plan for a patient with spontaneous pneumothorax ?

A
  • Usually requires surgical resection of the diseased lung
24
Q

List primary and secondary causes of spontaneous pneumothorax

A

Primary:
1. Pulmonary blebs or bullae that rupture (air filled cyst)

Secondary:
1. Lung disease (Ex: Neoplasia, asthma, PTE, pneumonia)

25
Q

List causes of iatrogenic pneumothorax

A

Lung damage during thoracocentesis (our fault)

26
Q

List causes of pneumomediastinum

A
  1. Tracheal trauma
  2. BDLD fight
  3. Tracheal FB
  4. Esophageal tear
27
Q

What is the most common cause of pneumomediastinum in cats?

A

tracheal trauma associated with endotracheal intubation + positive pressure ventilation

28
Q

Subcutaneous emphysema is a clinical finding in cats with

A. Pneumothorax
B. Pyothorax
C. Pneumomediastinum
D. Pleural effusion secondary to CHF

A

C. Pneumomediastinum

29
Q

What is the treatment protocol for patients with pneumomediastinum?

A

Supportive care with analgesics, O2, and close monitoring

If 2ndary pneumothorax develops, thoracocentesis may be required

30
Q

What clinical findings can be seen in a patient with pneumomediastinum?

A
  1. Subcutaneous emphysema (crunchy skin)
  2. Vomiting (cats)
  3. Tachypnea, dyspnea

SEM 5: SAM 1 (35 decks)

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