pleural disease

Question 1

what is mesothelioma?

Answer 1

a pleural malignancy

Question 2

what are symptoms of mesothelioma?

Answer 2

breathlessness
chest pain
weight loss
clubbed nails
pleural effusions

Question 3

how do you treat mesothelioma ?

Answer 3

mostly palliative
chemotherapy
trials
treating effusions

Question 4

what is a pleural effusion?

Answer 4

the imbalance between production and absorption

Question 5

what are the 2 types of effusion?

Answer 5

transudate (non inflammatory)

exudate (inflammatory)

Question 6

how would you differentiate an exudate effusion from a transudate?

Answer 6

an exudate effusion:
protein- pleural fluid/serum fluid ratio > 0.5
LDH- pleural fluid/serum fluid > 0.6

Question 7

what are transudate effusions usually caused by?

Answer 7

left ventricular failure

liver cirrhosis

Question 8

what are exudate effusions usually caused by?

Answer 8

malignancy
empyema
TB
parapneumonic effusions

Question 9

what tests would you use to diagnose an effusion?

Answer 9

ultrasound
cxr
thoracic ct (for complex effusions)

Question 10

when would you use a chest drain?

Answer 10

pH<7.2 with pneumonia, pus or blood

Question 11

how would you treat a transudate effusion?

Answer 11

treat underlying case

Question 12

how would you treat an exudate effusion?

Answer 12

further imaging and pleural biopsy

Question 13

what are the 5 types of pneumothorax?

Answer 13

primary spontaneous
secondary spontaneous 
traumatic
iatrogenic
tension

Question 14

whats the difference between a primary and secondary pneumothorax?

Answer 14

primary- occurs in normal, healthy lungs

secondary- occurs in pre-existing lung conditions, presents as chest pain/dyspnoea

Question 15

how do iatrogenic pneumothoraxes occur?

Answer 15

result of biopsy or pacemaker

Question 16

how do tension pneumothoraxes occur?

Answer 16

air builds up, pushes the central structures and squashes the opposite lung

Question 17

how would you treat a pneumothorax?

Answer 17

depending on the size ad severity:
observe
aspiration
chest drain
surgery

Question 18

what is meant by aspiration ?

Answer 18

green needle inserted to remove air