Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pulmonology > Pleural and Chest Wall Disorders > Flashcards

Pleural and Chest Wall Disorders Flashcards

1
Q

Inflammation of the pleura causes loss of lubricant between them,
inspiration causes the friction rub when the pleura rub together

A

Pleuritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some signs/symptoms of pleuritis?

A

Pain is localized, sharp, fleeting and made worse by coughing, sneezing, deep breath, or movement

Sharp pain like stabbing sensation – patient will be able to point out
exactly where it is felt

May hear a friction rub on inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is contraindicationed in a rib fracture?

A

Constrictive brace is contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Abnormal accumulation of fluid in pleural space

A

Pleural Effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two categories of pleural effusions?

A

transudative and exudative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The most common cause of pleural effusion is what?

A

congestive heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the pathophysiology of pleural effusions?

A

Fluid enters the space through capillaries and exits through lymphatics in the visceral and parietal pleura

Pleural effusions occur when there is an excess formation of pleural fluid, decreased fluid removal, or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the difference between transudative and exudative pleural effusions?

A

Exudative: Increased production of fluid due to abnormal capillary permeability or decreased lymphatic clearance (Capillaries are damaged)

Transudative: Increased production of fluid in the setting of normal capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the most common causes of exudative pleural effusions?

A

Bacterial pneumonia

Cancer (decreased lymphatic drainage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the subtypes of exudative pleural effusions?

A

Empyema
Hemothorax
Chylothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

infection in pleural space (abscess in the pleural space)

A

Empyema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

bleeding in pleural space (gross blood from trauma)

A

Hemothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

lymphatic fluid in pleural space (cholesterol complex accumulation, appears white)

Associated with lymphoma and thoracic surgery

A

Chylothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Exudative pleural effusions criteria: one or more of the following

Note: transudates have NONE of these features

A

Pleural fluid protein to serum protein ratio >0.5

Pleural fluid LDH to serum LDH ratio >0.6 and pleural fluid LDH greater than two thirds the upper limit of normal serum LDH

LDH = lactose dehydrogenase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Transudates differentiated from exudates by what criteria?

A

Light’s Criteria

Looks at LDH and protein (compare to serum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the most common causes of transudative pleural effusions?

A

Congestive heart failure – one of the most common causes
Hypoproteinemia (Nephrotic syndrome)
Cirrhosis
Pulmonary embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the gold standard treatment for pleural effusions?

A

Thoracentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If the protein is <3gm%, which type of pleural effusion do you have?

A

Transudate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If the protein is >/= 3gm%, which type of pleural effusion do you have?

A

Exudate

20
Q

Which two types of cancer commonly have malignant pleural effusions?

A

Lung cancer
breast cancer

21
Q

Accumulation of air in the pleural space

A

Pneumothorax

22
Q

What are the types of pneumothorax?

A

Primary spontaneous pneumothorax
Secondary spontaneous pneumothorax
Tension pneumothorax

23
Q

Type of pneumothorax that occurs in the absence of underlying disease?

A

Primary spontaneous pneumothorax

24
Q

Type of pneumothorax that occurs in the presence of underlying disease?

A

Secondary spontaneous pneumothorax

25
Q

What is the most common disease that can result in a secondary spontaneous pneumothorax?

A

COPD

26
Q

What is the classic patient demographic that you may see a primary spontaneous pneumothorax?

A

tall, thin males
men between the ages of 18-40
smoking increases risk 20x

27
Q

Positive pressure in the pleural space throughout the respiratory cycle

A

Tension pneumothorax

28
Q

Spontaneous Pneumothorax is common in patients with which disorder?

A

Marfan’s Syndrome

29
Q

If you have severe tachycardia, hypotension, and mediastinal or
tracheal shift, which type of pneumothorax should you suspect?

A

tension pneumothorax

30
Q

What therapy may hasten the resolution of pneumothorax?

A

Oxygen

31
Q

What imaging is diagnostic? What is the exception?

A

CXR

Exception: tension pneumothorax

32
Q

What are some complications of a pneumothorax?

A

Subcutaneous emphysema
Pneumomediastinum
death

33
Q

Tension pneumothorax will result in what?

A

acute respiratory failure and potentially death

34
Q

What are the two common etiologies of a tension pneumothorax?

A

Traumatic
Barotrauma (i.e. mechanical ventilation)

35
Q

What is the most common cause of a tension pneumothorax?

A

trauma

36
Q

In a tension pneumothorax, you’d see a tracheal +/or mediastinal shift
toward which side?

A

the unaffected side
(contralateral hemithorax)

37
Q

If a tension pneumothorax is suspected, a large-bore needle should be inserted immediately in the affected side for decompression at which site?

A

second intercostal space in midclavicular line

38
Q

A primary tumor predominately of pleural surface lining, arising from the mesothelial cells that line the pleural cavities or peritoneum

known as the only pleural cancer

“pleural-based mass”

A

Mesothelioma

39
Q

Malignant pleural mesotheliomas are commonly associated with what exposure?

A

asbestos exposure

40
Q

In mesothelioma, what percentage of patients will you expect to see extra-thoracic spread?

A

> 90% of patients

41
Q

In mesothelioma, what percentage of cases are diffuse (malignant) v localized (benign)?

A

75% are diffuse (malignant)

25% are localized (benign)

42
Q

What is the most common first sign of mesothelioma we’ll come across?

A

Pleural effusions

43
Q

In mesothelioma, what is the median survival rate in localized disease?

A

16 months in localized disease

44
Q

In mesothelioma, what is the median survival rate in extensive disease?

A

4 months in extensive disease

45
Q

What diagnosis should you consider if you see the following clinical presentation:

Insidious onset of SOB
Non-pleuritic chest pain
Weight loss

A

mesothelioma

Pulmonology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions