Flashcards in Diseases of Pleura Deck (26)
intraalveolar greater or less pressure than intrapleural?
intrapleural pressure is always greater
what causes increased fluid entry?
increase microvascular pressure
decrease oncotic (pull) pressure
blockage of lymphatics
protein serum vs. protein in effusion fluid to determine transudate vs. exudate?
what else to look for in effusion fluid samples?
pH (anaerobic metabolism)
other investigations for pleural effusion?
pleuritic chest pain just pleura?
nope, all organs around it, including muscles
breath sounds in air or fluid are?
what can mimic a pleural effusion?
raised hemi diaphragm
unilateral effusion cause?
primary lung cancers
heart failure but less common
bilateral effusion cause?
low-pressure states (low oncotic pressure)
what is a chylothorax?
lymph with chylomicrons effusions into
why do you get air in pleural space?
spontaneous (smoking, FHx, Marfan's)
underlying lung disease (COPD, lung bullae)
how to manage air in pleural space?
could resolve spontaneously
-drainage: aspiration, ICC with underwater seal (one way valve)
-pain relief, O2
why O2 speed up resolution of pneumothorax?
concentration gradient to push nitrogen out and O2 into tissues
chest tube has stopped swinging, why?
Tube slipped into subcut or was never in the right space
Tube tap is in wrong spot.
when take out the tube?
no air leaks
what is fluid in a CT pleural effusion that doesn't change with gravity?
loculated pleural fluid
what could cause loculated pleural fluid?
what to do with empyema?
when to intervene with tube? re: pH?
chest tube size matter for empyema?
not really, but with loculated, use DNA-ase, tPA to break it down.
talc: active inflammation to stick
what causes pleural plaques?
TB or blood in pleural space
mesothelioma uni or bilateral usually?
pleural plaques turns into mesothelioma?
Nope, just increased risk