Chest Wall, Pleural and Pulmonary Disorders Flashcards Preview

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Flashcards in Chest Wall, Pleural and Pulmonary Disorders Deck (18)
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1

What is a pneumothorax?

Air in the pleural space

2

Who is more likely to get a spontaneous pneumothorax?

Tall, thin males

3

How is pneumothorax treated?

Needle aspirate 2nd ICS, mid-clavicular line
Chest drain 5th ICS mid-axillary line with large cannula if unresolved

4

What is an exudate in the pleural space of pH less than 7.2 highly suggestive of?

Empyema

5

What is pleural effusion?

Fluid in the pleural space

6

What are the features of a transudate?

Protein less than 30g/l
LDH less than 200

7

Which conditions cause transudate?

Heart failure
Nephrotic syndrome
Pericarditis

8

What are the features of an exudate?

Protein more than 30g/l
LDH more than 200

9

Which conditions cause exudate?

TB
Pneumonia
Cancer
MI
Pancreatitis

10

Pleural effusions can be clinically detected when more than 300ml is present. True/False?

False
Only when more than 500ml is present

11

How much fluid is required in pleural effusion to be detected on a CXR?

More than 300ml

12

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

13

List some symptoms and signs of pulmonary hypertension

Ankle oedema
Progressive breathlessness
Elevated JVP
Ascites
Parasternal heave/tricuspid regurgitation

14

How do pulmonary embolisms most commonly arise?

Thrombus from legs gets stuck in pulmonary arteries

15

What are the 3 components of Virchow's Triad?

Damage to endothelium
Abnormal blood flow
Hypercoagulable blood

16

What are some symptoms of PE?

Sudden breathlessness
Sudden pleuritic pain
Tachypnoea
Fever

17

If D-dimer is undetected in investigations, rule out PE diagnosis completely. True/False?

True

18

Apart from D-dimer, what are useful investigations to do for PE?

V/Q scan (show underperfused areas)
CTPA is gold standard for diagnosis