Pneumo - Derrame Pleural Flashcards

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1
Q

Quadro clínico DP

A

Tosse
Dispneia
Dor ventilatorio dependente

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2
Q

Cuidado na toracocentese

A

Nao retirar mais que 1500ml pelo risco de edema de reexpansao

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3
Q

Contra indicação toracocentese

A

Discrasia sanguinea

Plaquetopenia

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4
Q

Análise do líquido pleural

A

Critérios de Light

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5
Q

Critérios de Light

A

Ptn liquido/ptn serica >0,5
DHL liquido/DHL serico >0,6
DHL liquido >2/3 do LSN

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6
Q

Exsudato

A

Presença de pelo menos 1 critério de light

Ptn pleural/ptn serica >0,5
Dhl pleural/dhl serico >0,6
Dhl pleural >2/3 do LSN

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7
Q

Transudato

A

Todos os criterios de light ausentes

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8
Q

Principal causa de derrame transudativo

A

IC (DP bilateral com predominio a direita)

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9
Q

DP na TEP

A

Transudato ou exsudato

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10
Q

Causas de DP exsudativo

A

PNM
Neoplasia
Tb
Inflamação

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11
Q

DP com pus

A

Empiema

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12
Q

DP hematico

A

Neoplasia

TEP

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13
Q

DP leitoso

A

Quilotorax

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14
Q

DP na cirrose

A

Transudato

Ascite

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15
Q

DP neoplasico

A
Pulmao
Mama
Linfoma
Hematico
Linfocitico
Recidivante
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16
Q

Toracocentese inconclusiva na suspeita de DP neoplasico

A

Biopsia pleural

17
Q

Toracocentese inconclusiva na suspeita de DP neoplasico

A

Biopsia pleural

18
Q

DP quiloso

A

Leitoso
Trauma/linfoma
Linfocitico
TG>110mg/dL

19
Q

DP no LES

A

Linfocitico

Glicose normal

20
Q

DP na AR

A

Exsudato linfocitico

Glicose baixa

21
Q

DP parapneumonico nao complicado conduta

A

ATB

22
Q

DP parapneumonico complicado conduta

A

Drenagem

23
Q

DP na TB

A

Linfocítico
ADA >40
Mesoteliocitos <5%
Biopsia pleural (granuloma)

24
Q

DP com metamielocitos <5%

A

Tuberculoso

25
Q

DP com ADA >40U

A

Tb
Linfoma
Parapneumonico

26
Q

Ph no DP por proteus

A

> 7,5

27
Q

DP na pneumocistose

A

Raro

28
Q

DP na pancreatite

A

Exsudato
Amilase alta
Glicose normal

29
Q

Conduta empiema agudo

A

Drenagem pleural fechada (selo d’água)