Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3: MED1 Y3 - Respiratory [18] > [6] Pleural Effusion > Flashcards

[6] Pleural Effusion Flashcards

(67 cards)

Start Studying
1
Q

What is a pleural effusion?

A

When the volume of fluid in the pleural space is substantially greater than normal

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

What kind of disease can pleural effusions be caused by?

A

Disease that is pulmonary, pleural, or extrapulmonary

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

What covers the lungs?

A

A thin serious layer, called the visceral pleura

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

What covers the chest wall and pericardium?

A

The parietal pleura

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

How are the visceral and parietal pleura related?

A

The parietal pleura is a reflection of the visceral pleura, and they are connected at the lung hila

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

What is the space inbetween the visceral and parietal pleura called?

A

The pleural space

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

What is found in the pleural space?

A

A very small amount of fluid

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

What is the purpose of the fluid in the pleural space?

A

It lubricates movement between the layers

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

What can pleural effusions be classifed as?

A

Transudates or exudate

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

Other than transudates and exudates, what can accumlate in the pleural space?

A
  • Blood
  • Pus
  • Chyle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is it called when blood accumulates in the pleural space?

A

Haemothorax

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

What is it called when pus accumulates in the pleural space?

A

Empyema

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

What is it called when chyle accumulates in the pleural space?

A

Chylothorax

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

When does a transudative pleural effusion occur?

A

When there is disruption of the hydrostatic and oncotic forces operating across the pleural membranes

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

When does an exudative pleural effusion occur?

A

When there is increased permeability of the pleural surface and/or capillaries, usually as a result of inflammation

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

How are pleural effusions divided into transudative and exudative?

A

On the basis of the Light criteria

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

What does the Light criteria consist of?

A

The measureent of lactate dehydrogenase (LDH) and protein concentration in the pleural fluid and serum

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

What are the Light criteria?

A

Fluid is considered exudative if one of the following is present;

  • Pleural fluid-to-serum protein ratio is >0.5
  • Plueral fluid-to-serum LDH ratio is >0.6
  • Pleural fluid LDH concentration > 2/3 upper limit of normal serum LDH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the most common causes of transudate pleural effusions?

A
  • Heart failure
  • Cirrhosis
  • Hypoalbuminaemia
  • Peritoneal dialysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the less common causes of pleural effusion?

A
  • Hypothyroidism
  • Nephrotic syndrome
  • Pulmonary embolism
  • Mitral stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the most common causes of exudate pleural effusions?

A
  • Pneumonia
  • Malignancys
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the most common malignancies causing pleural effusion?

A

Lung cancer in men, breast cancer in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What kind of pleural effusoins are most commonly due to malignancy?

A

Large, unilateral pleural effusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the less common causes of exudate pleural effusions?

A
  • Pulmonary infarction, resulting from pulmonary embolism
  • Autoimmune disease, especially RA
  • Asbestos exposure
  • Pancreatitis
  • TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is a chylothorax?
The presence of chyle in the pleural space
26
What does a chylothorax usually occur due to?
Disruption of the thoracic duct
27
What are the causes of a chylothorax?
* Neoplasm * Trauma * TB * Sarcoidosis * Cirrhosis * Amyloidosis
28
What neoplasms can cause a chylothorax?
* Lymphoma * Metastatic carcinoma
29
What trauma can cause a chylothorax?
Operative and penetrating injuries
30
When are pleural effusions symptomatic?
An effusion has to be quite large before it causes any symptoms, however most malignant effusions are symptomatic
31
What are the symptoms of a pleural effusion?
* Shortness of breath, especially on exertion * Cough * Pleuritic chest pain
32
What other history features should be noted with pleural effusion?
* Loss of weight, which may suggest malignancy * Smoking and haemoptysis, which might suggest lung cancer * History of another malignancy
33
How is a pleural effusion investigated?
* Examination * CXR * Other imaging, including CT, MRI, and ultrasound * Pleural fluid analysis
34
What may be seen on inspection on examination in pleural effusion?
* Signs of lung pathology * Chest expansion may be reduced, bilaterally or unilaterally * Dyspnoea * Signs of underlying cause
35
What signs of lung pathology may be seen on examination in pleural effusion?
* Nicotine staining on dfingers * Accessory muscles of respiration use * Finger clubbing
36
What signs of an underlying cause may be seen on examination in pleural effusion?
* Signs of weight loss * Rheumatoid changes in hands
37
Describe chest expansion in pleural effusion
It is reduced on the side of the effusion
38
How is the trachea deviated in pleural effusion?
With a large, unilateral effusion, the trachea is deviated away from the lesion If there is associated collapse, the trachea is deviated towards the lesion
39
What may be found on palpation in examination in pleural effusion?
May be decreased tactile vocal fremitus
40
What may be found on percussion in pleural effusion?
Effusion will cause stony dullness on percussion. Laterally, it will rise upwards towards the axilla
41
What will be found on ausculatation in pleural effusion?
* Breath sounds diminished or absent over effusion * Vocal resonance lost over pleural effusion, except at it's upper surface
42
What is the first-line investigation in suspected pleural effusion?
CXR
43
How big must a pleural effusion be to be visible on a CXR?
About 200ml to be seen on a PA, or 50ml to cause costophrenic blunting on lateral view
44
Other than detecting fluid, what can a CXR be useful for in pleural effusion?
May suggest an underlying cause, e.g. heart failure
45
What is the advantage of ultrasound over CXR in pleural effusion?
It is much more sensitive than CXRs in detecting pleural effusions, and can detect even very small effusions
46
What things are looked at when interpreting pleural fluid analysis
* If it is transudate or exudate * Pleural fluid haematocrit * pH * Cytology * Lipids * Glucose
47
What is classification of transdate or exudate in pleural fluid analysis based on?
Pleural protein content
48
What can bloody pleural fluid be caused by?
* Malignancy * Pulmonary embolus with infarction * Trauma * Benign asbestos pleural effusions
49
What can pleural fluid haematocrit help determine?
If a pleural effusion is a haemothorax
50
What can pH help determine in the analysis of pleural fluid?
If pleural effusion is a haemothorax
51
What is the normal pH of pleural fluid?
Around 7.6
52
What can cause a pleural pH of \<7.2 with normal blood pH?
* Pleural infection and empyema * Rheumatoid disease and SLE * TB * Malignancy
53
What is the importance of cytology in pleural fluid analysis?
It is required to diagnose malignant effusions
54
Why are lipids looked at in pleural fluid analysis?
Determine if chylothorax
55
Where may low pleural glucose levels be found?
* Empyema * Rheumatoid disease and SLE * TB * Malignancy
56
What should the management of pleural effusion be aimed at?
The underlying disease
57
When should aspiration be avoided in pleural effusion?
If transudate is confirmed
58
How are small effusions that are not causing respiratory problems managed?
Observation
59
What is the advantage of tapping in pleural effusion?
* It can give symptomatic relief * Useful for diagnosis
60
What is the disadvantage of tapping pleural effusions?
Effusion is likey to reform
61
Where may repeated tapping be used in pleural effusion?
In pallative care
62
How can controlled drainage of an effusion be achieved?
Insertion of a chest drain
63
When are chest drains removed in pleural effusion?
If/when the underlying disease is treated
64
In what kind of pleural effusions are chest drains often needed?
* Empyema * Haemothorax
65
What is pleurodesis?
The injection of sclerosant to cause adhesion of the visceral and parietal pleura, and to help prevent reaccumulation of the effusion
66
What are some commonly used sclerosing agents in pleurodesis?
* Tetracycline * Sterile talc * Bleomycin
67
Where is pleurodesis most commonly used in pleural effusion?
In the management of recurrent malignant effusions

3: MED1 Y3 - Respiratory [18] (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions