Pleurisy

Question 1

DDX

Answer 1

Infection
Pulmonary embolus
Malignancy
Trauma eg cough fractures

Question 2

Ix for pleural effusion

Answer 2

diagnostic aspiration -
- Transudates - cardiac failure, hypoalbuminaemia
- Exudates - infection, malignancy e.g. mesothelioma, CT disease e.g. rheumatoid disease or pulmonary infarction.
Light criteria looking at protein and LDH in aspirate vs serum.

Question 3

Mx of pleural effusion

Answer 3

Pain relief

Surgery - aspirate fluid if small or if haemothorax. For larger one please need to insert a drain

Question 4

Mx of Pleurisy

Answer 4

CXR and WCC
If abnormal then treat as pneumonia
Pain relief either way.

Question 5

Spontaneous Pneumothorax

Answer 5

Presentation - M greater then F, sudden breathlessness and pleuritic chest pain
EX - reduced breath sounds and increase percussion note.
Ix - CXRis dX
Mx - aspiration or chest drain (if effecting ventilation).
Look for underlying cause

Question 6

Tension pneumothorax

Answer 6

Presentation - Increasing/severe breathlessness, cyanosis, deviated trachea, absence of BS on one side,
Mx - Decompression. Medical emergency.