Clinical: Pleural Disease Flashcards Preview

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Flashcards in Clinical: Pleural Disease Deck (12):
1

Most sensitive layer when performing a pneumocentesis.

Parietal Pleura

2

Layer of tissue that reabsorbs pleural fluid.

Parietal Pleura

3

Function of pleural mesothelial cells

Phagocytic
Maintain balance between coagulation and fibrinolysis

4

Where does the pleural fluid originate and where does it drain?

Diffuses into the pleural space from the bronchial and intercostal mircoarteries.

Drains into the bronchial and intercostal veins along with lymphatic vessels.

5

What two mechanisms cause an increase in pleural fluid?

Increased fluid entry due to starling force imbalance

Decreased fluid exit due to inflammation, obstruction (lymphomas), heart failure, or endocrine abnormalities

6

In which systemic conditions is pleural inflammation common?

Lupus, hypothyroidism, amyloid, yellow nail syndrome

7

What are the 3 major causes of pleural fluid transudate?

Cardiac Disease
Kidney Disease
Liver Disease

8

What is Light's Diagnostic Criteria for a fluid to be considered exudate?

1. Pleural fluid protein/serum ratio greater than 0.5
2. Fluid LDH/serum ratio greater than 0.6
3. Fluid LDH greater than 2/3 of the upper limit of lab normal for LDH

-if one of these is true=exudate
(LDH is lactate dehydrogenase)

9

What are the 3 most important components analyzed in pleural fluid chemical analysis?

Protein
LDH
Glucose

10

What 3 conditions can increase fluid protein concentrations toward the exudate range?

1. Diuresis
2. CHF
3. TB infection

11

What conditions can increase serum LDH levels?

Empyema, rheumatoid pleurisy, pleural paragonimiasis (worm infection), malignancy

12

What 2 major conditions can cause increased glucose levels in pleural fluid?

1. Rheumatoid Pleurisy
2. Complicated parapneumonic effusion or empyema