Pleuritis

Question 1

Essentials of Diagnosis for what?
(1) Sudden onset of intermittent (fleeting) pain in the chest wall.
(2) Usually follows an injury or illness.
(3) Pain worsened by coughing, sneezing, deep breathing, or movement.

Answer 1

Pleuritis

Question 2

______ is inflammation of the pleura

Answer 2

Pleuritis

Question 3

In the young otherwise healthy patient, pleuritis is caused by _______ or _______

Answer 3

viral respiratory illness or pneumonia

Question 4

Trauma to the chest wall such as rib fractures may also cause _______ pain.

Answer 4

pleuritic pain

Question 5

True/False
The setting in which the pleuritic pain develops helps narrow the differential diagnosis.

Answer 5

True

Question 6

Even in the absence of parenchymal abnormalities, pleuritic chest pain may lead to splinting and atelectasis significant enough to produce _______.

Answer 6

hypoxemia

Question 7

The Pt presents with theses issues during PE what do you suspect.
(1) Pleuritic chest pain may produce a sense of dyspnea.
(2) Pain is usually localized, sharp, and fleeting.
(3) It is made worse by coughing, moving, and breathing.
(4) Friction rub may be present on lung auscultation.
-If present, rub may lessen or disappear when effusion occurs.
(5) Pain may refer to the ipsilateral shoulder.
(6) Fever, Myalgia’s, headache, nasal congestion, or flu-like symptoms may also be present.

Answer 7

Pleuritis

Question 8

What are you using CXR for in helping your Dx

Answer 8

exclude underlying lung disease, pleural effusion, or pneumothorax

Question 9

What are some ddx for Pleuritis

Answer 9

(1) Cardiac
(2) Pulmonary
(3) Trauma
(4) GI
(5) Musculoskeletal
(6) Psych

Question 10

What is the main goal in treatment of pleuritis?

Answer 10

detect and treat the underlying lesion or cause

Question 11

What are some Med choices for pleuritis

Answer 11

Analgesic / Antipyretic / Non-Steroidal Anti-Inflammatory Drugs (NSAID).
-Acetaminophen 325-1000 mg PO q 4-6 max 4g/24h
-Aspirin 160-325 mg daily
-Nsiads
Codeine - T3 300/30mg 1-2 tabs q4h.
Morphine 2-8 mg intravenously may be repeated after 2-4 hours

Question 12

Disposition for Pleuritis

Answer 12

Based on underlying cause.

Question 13

Disposition for Pleuritis
If the underlying disease requires hospital treatment or if parenteral analgesics are required for pain control

Answer 13

MEDEVAC

Question 14

Disposition for Pleuritis
If the patient is hypoxic

Answer 14

MEDEVAC

Question 15

What is the complication(s) from Pleuritis

Answer 15

Atelectasis, respiratory splinting secondary to pain, or pneumonia