Chest Wall, Pleural and Pulmonary Disorders Flashcards
(31 cards)
What are the symptoms of chronic pulmonary infection? (5)
Shadow on CXR Weight loss Persistant sputum production Chest pain SOB
What are the risk factors for chronic pulmonary infection?
Abnormal innate host defence
Repeated insult
Abnormal host response
How do you differentiate between an intrapulmonary abscess and an empyema?
Typically follow a preceding illness - use CT
ABSCESS: looks like an orange
EMPYEMA: pus in the pleural space - looks like a banana, D sign on CXR
How do you manage an empyema?
Drainage
IV/oral antibiotics
Define bronchiectasis and give management options…
Localised irreversible dilatation of bronchial tree, bronchi can collapse and makes it difficult to clear infection
No treatment via antibiotics, stop smoking, vaccinate
Define pulmonary oedema and give signs…
Accumulation of fluid in the lung (similar to pneumonia but pus not infected)
RESTRICTIVE pattern, dyspnoea, pink frothy sputum
Give a localised and generalised cause of pulmonary oedema
Pneumonia
ARDS
What is ARDS? Appearance of CXR? What can it lead to?
Acute lung injury due to direct trauma or secondary to severe systemic illness
BILATERAL ALVEOLAR SHADOWING
Fibrosis —> chronic restrictive lung disease
Describe the basic anatomy of the pleura…
Visceral layer covering lungs and forming fissures
Parietal layer covering mediastinum, diaphargm, thorax
No pleura at hilum
What is pleural effusion? Appearance of CXR?
Fluid in the pleural space
Meniscus visible - lung being pushed into fluid
List signs of a pleural effusion
Reduced chest expansion
Reduced breath sounds
Stony dull percusion note
List diagnostic techniques in pleural effusion
CXR
Cytology
Pleural aspirate
Pleural biopsy
What is an exudate in the pleural space of pH less than 7.2 highly suggestive of?
Empyema
What are the features of a transudate?
Which conditions cause transudate? (3)
Protein less than 30g/l LDH less than 200
Heart failure
Nephrotic syndrome
Pericarditis
What are the features of an exudate?
Which conditions cause exudate? (5)
Protein more than 30g/l LDH more than 200 TB Pneumonia Cancer MI Pancreatitis
Pleural effusions can be clinically detected when more than 300ml is present. True/False?
False Only when more than 500ml is present
How much fluid is required in pleural effusion to be detected on a CXR?
More than 300ml
What is a pneumothorax? Signs?
Air in the pleural space —> uncoupling of lung from chest wall
Dyspnoea, pleuritic chest pain, hypersonance, reduced
chest expansion and breath sounds
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
Investigations used for pneumothorax…
CXR
CT chest
What is a tension pneumothorax? Signs?
Progressive build up of air in pleural space
Tachycardia, hypotension, elevated JVP, trachea deviation AWAY from side of injury, hyperesonance, reduced breath sounds
Common causes of tension pneumothorax…
Respiratory disease Misplaced/ blocked drain CPR Trauma Ventilation
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
