Pleurisy Flashcards
What is pleuritic chest pain?
chest pain precipitated by movement or forceful breathing, tends to be sharp in nature
What symptom often accompanies pleuritic chest pain and why?
often accompanied by perception of dyspnoea which may be secondary to suppression of respiration
What is the cause of pleuritic chest pain?
irritation of the nerves in the parietal pleura - the visceral pleura has no innervation
What are 6 examples of causes of pleuritic chest pain?
- Pulmonary embolism
- Pneumothorax
- Pneumonia
- Pericarditis
- Myocardial infarction
- Pneumomediastinum
What is pleurisy?
refers to inflammation of the pleura and also the symptoms - strictly should use pleurisy for name of condition and pleuritic pain for the symptom
What is the typical nature of pleuritic pain?
typically described as sharp in nature
classically exacerbated by any action involving a vigorous inspiration/expiration e.g. sneezing, laughing, coughing, deep breathing
chest wall tenderness may be present, occasionally pleural rub can be heard
What are 7 possible aetiologies of pleurisy i.e. inflammation of pleura (rather than pleuritic chest pain)?
- Infection: viral, bacterial, parasitic
- Exogenous agents: absestos, drugs
- Inflamatory: RA, lupus, Sjögren syndrome
- Cardiac: Dressler syndrome
- GI: IBD, spontaneous bacterial pleuritis
- Familial Mediterranean fever
- Renal: chronic renal failure
What are 6 examples of viruses which can cause pleurisy?
- Adenovirus
- Coxsackie
- Cytomegalovirus
- Epstein-Barr virus
- Influenza
- Mumps
What are 2 examples of bacterial causes of pleurisy?
- Tuberculosis
- Parapneumonic pleuritis
What is a parasite which can cause pleurisy?
amoebiasis
What are 12 examples of exogenous agents which can cause pleurisy?
- asbestos
- amoidarone
- bleomycin
- bromocriptine
- cyclophosphamide
- methotrexate
- methysergide
- minoxidil
- mitomycin
- oxyprenolol
- practolol
- procarbazine
What is medication-induced pleurisy distinct from?
interstitial lung disease which many of the agents also cause
What are 3 examples of inflammatory causes of pleurisy?
- Rheumatoid arthritis
- Lupus pleuritis
- Sjögren syndrome
What are 2 GI causes of pleurisy?
- Inflammatory bowel disease
- Spontaneous bacterial pleuritis
What are 7 differentials for pleurisy?
- Pulmonary embolism
- MI - pleuritic pain atypical but well-recognised
- Pneumothorax
- Pericarditis
- Pneumonia
- Trauma
- Bornholm disease
