Pleural Effusions Flashcards

1
Q

acute, painful, pleural inflammation caused by parietal pleural irritation

A

pleuritis

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2
Q

what is the cause of pleuritis in healthy individuals?

A

viral or bacterial infection

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3
Q

what should be considered to be the cause of pleuritis in an ill patient? (2)

A

malignancy
effusion

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4
Q

a patient presents with localized, sharp, and fleeting pain that is worse when coughing, sneezing, or deep breathing.

A

pleuritis

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5
Q

where can pain in pleuritis refer to?

A

ipsilateral shoulder

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6
Q

what is the treatment for pleuritis?

A

underlying cause
NSAIDs
cough suppressant

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7
Q

pleural effusion that is caused by increased hydrostatic or decreased oncotic capillary pressure

A

transudative

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8
Q

pleural effusion caused by increased production of fluid

A

exudative

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9
Q

infection leading to pus in the pleural space

A

empyema

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10
Q

what is hydrostatic pressure’s job?

A

pushes out fluid from vessels

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11
Q

what is oncotic pressure’s job?

A

keeps in fluid from vessels

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12
Q

what is the pathophysiology of transudative effusions?

A

low pleural fluid concentration of proteins and other large molecules

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13
Q

what is the most common cause of transudative pleural effusion?

A

heart failure

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14
Q

what is the pathophysiology of exudative pleural effusion?

A

increased permeability leads to elevated levels of proteins and other large molecules in the pleural fluid

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15
Q

an exudative free flowing effusion that is small and resolves completely with antibiotics

A

uncomplicated parapneumonic effusion

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16
Q

an exudative free flowing effusion that requires drainage

A

complicated parapneumonic effusion

17
Q

an exudative collection of pus in the pleural space in which the lung adheres to the chest wall as inflammation leads to scarring

18
Q

a patient presents with dyspnea, cough, pleural chest pain, dullness to percussion, egophony.

A

pleural effusion

19
Q

what would a chest xray look like in pleural effusion? (2)

A

fluid in gravity-dependent areas
costophrenic blunting

20
Q

what does an empyema look like in pleural fluid gross exam?

A

purulent, white and milky

21
Q

what is done in a pleural effusion for testing and therapeutic benefit?

A

thoracentesis

22
Q

what would pH and WBC count be in transudative pleural fluid?

A

7.4-7.55 (alkaline)
<1000

23
Q

what is light’s criteria for exudative pleural effusion?

A

pleural protein/serum protein > 0.5
pleural LDH/serum LDH > 0.6
pleural LDH > 2/3 x serum LDH

24
Q

what is the most common cause of exudative pleural effusions?

A

lung and breast cancer

25
a lack of tumor cells on cytology with presumed malignancy etiology
para-malignant effusion
26
what is the treatment for transudative and malignancy pleural effusion?
treat underlying cause therapeutic thoracentesis
27
what is the treatment for an uncomplicated parapneumonic pleural effusion?
treat infection
28
what is the treatment for a complicated parapneumonic pleural effusion? (3)
treat infection drain fluid peel fibrous adhesions