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T year LOBS surgery > cardiothoracic > Flashcards

Flashcards in cardiothoracic Deck (19):
1

what is a pleural effusion?

the accumulation of fluid in the pleural space that can be transudate or exudate

2

what are symptoms of a pleural effusion?

- dyspnoea
- pleuritic chest pain
- cough
- fever
- chills
- weight loss

3

what is transudate?

low protein content due to cahnges in oncotic and hydrostatic forves

4

what are causes of transudate pleural effusion?

congestive heart failure
ascites
cirrhosis
hypoalbuminaemia
nephrotic syndrome

5

what is exudate?

high in protein and contains more lactate dehydrogenase
due to inflammatory/ infection neoplastic syndromes

6

what is the medical management options for a pleural effusion?

- diuretics
- physio
- antibiotics

7

what diuretics are good for pleural effusion?

- often durosemide is used
- if they have refractory volume overload non loop diuretics can be helpful

8

what antibiotics are good for pleural effusion?

- amoxicillin
- clindamycin
- not aminoglycosides

9

what are surgical options for pleural effusion?

- therapeutic thoracocentesis
- tube thoracostomy
- drainage catheter placement
- pleurodesis

10

what is therapeutic thoracocentesis?

A needle catheter is used going above the rib in the lateral chest wall

11

when is thoracocentesis used for pleural effusion?

- larger than 1cm
- causing symptoms
- doesn't meet the criteria for chest drainage

12

what are possible complications of thoracocentesis?

- pneumothorax
- haemothorax
- laceration

13

what is pleurodesis?

obliteration of the pleural space to prevent recurrent pleural effusions

14

what agents are typically used for pleurodesis?

- talc
- silver nitrate

15

what are medical options for a pneumothorax?

- high flow oxygen
- chemical pleurodesis

16

when is high flow oxygen used for pneumothorax?

- patients with a secondary pneumothorax that is under 1cm and observed for 24 hours

17

what are surgical options for pneumothorax?

- intercostal drain
- aspiration
- chest drain

18

what is the first line treatment surgically for all pneumothoraxs needing intervation?

aspiration

19

when is chest drain suction used for a pneumothorax?

- tension
- over 2cm making them breathless