Week 106: Pleurisy

Question 1

What is pleuritic pain?

Answer 1

• Sharp
• Stabbing
• Localised
• Relieved by shallow breathing

Question 2

What does a pleural rub sound like?

Answer 2

Feet crunching on snow

Question 3

What is a transudate pleural effusion like?

Answer 3

• Due to any system failure
• Clear
• Low protein concentration

Question 4

What is an exudate pleural effusion like?

Answer 4

• Due to inflammation mainly
• High protein concentration
• Due to infection: pneumonia, TB
• Due to malignancy
• Due to pulmonary infarction

Question 5

What is and how would you manage a small pneumothorax?

Answer 5

• t treat, allow to reabsorb

Question 6

What is a pneumothorax?

Answer 6

Air in the pleural space

Question 7

What is a haemothorax?

Answer 7

Blood in the pleural space

Question 8

What is a chylothorax?

Answer 8

Lymph in the pleural space

Question 9

What is and how would you manage a large pneumothorax?

Answer 9

• > 2cm

- Insert a chest drain

Question 10

Where would you insert a chest drain?

Answer 10

Above the fourth-fifth intercostal space, mid-axillary line

Question 11

What is a tensionpneumothorax?

Answer 11

Pressure from lung collapse increasing until the heart shifts over

Question 12

What is a simple pneumothorax?

Answer 12

Lung collapse

Question 13

How would you manage a tensionpneumothorax?

Answer 13

Needle into second intercostal space, mid-clavicular line

Question 14

What can turn a simple pneumothorax into a tensionpneumothorax?

Answer 14

• Flying
• Etinox (painkiller for pregnant women in labour)
• Trauma

Question 15

What is the V/Q ratio?

Answer 15

• Ventilation/perfusion ratio
• Breath in: easiest to ventilate top of lungs
  
  • Therefore, top best ventilated
  • Bottom worst ventilated
• Perfusion
  
  • Bottom best perfused
  • Top worst perfused (more difficult)
• To absorb lots of O2, high in alveoli and blood levels
• Base of lungs best balance