Chest Wall, Pleural and Pulmonary Disorders Flashcards
What is a pneumothorax?
Air in the pleural space
Who is more likely to get a spontaneous pneumothorax?
Tall, thin males
How is pneumothorax treated?
Needle aspirate 2nd ICS, mid-clavicular line
Chest drain 5th ICS mid-axillary line with large cannula if unresolved
What is an exudate in the pleural space of pH less than 7.2 highly suggestive of?
Empyema
What is pleural effusion?
Fluid in the pleural space
What are the features of a transudate?
Protein less than 30g/l
LDH less than 200
Which conditions cause transudate?
Heart failure
Nephrotic syndrome
Pericarditis
What are the features of an exudate?
Protein more than 30g/l
LDH more than 200
Which conditions cause exudate?
TB Pneumonia Cancer MI Pancreatitis
How much fluid is required in pleural effusion to be detected on a CXR?
More than 300ml
What is cor pulmonale? How does it arise?
Right heart failure due to pulmonary hypertension
Alveolar damage causes reduced gas exchange (hypoxia), causing pulmonary vasoconstriction which builds up pressure in the right heart
List some symptoms and signs of pulmonary hypertension
Ankle oedema Progressive breathlessness Elevated JVP Ascites Parasternal heave/tricuspid regurgitation
How do pulmonary embolisms most commonly arise?
Thrombus from legs gets stuck in pulmonary arteries
What are the 3 components of Virchow’s Triad?
Damage to endothelium
Abnormal blood flow
Hypercoagulable blood
What are some symptoms of PE?
Sudden breathlessness
Sudden pleuritic pain
Tachypnoea
Fever
