Diseases of Pleura Flashcards Preview

Jason's MD2 ED/Amb Rotation > Diseases of Pleura > Flashcards

Flashcards in Diseases of Pleura Deck (26):
1

intraalveolar greater or less pressure than intrapleural?

intrapleural pressure is always greater

2

what causes increased fluid entry?

increase microvascular pressure
increase permeability
decrease oncotic (pull) pressure
blockage of lymphatics

3

protein serum vs. protein in effusion fluid to determine transudate vs. exudate?

Light's criteria

4

what else to look for in effusion fluid samples?

pH (anaerobic metabolism)
white cells
blood
LDH
glucose
micro
cytology
TB

5

other investigations for pleural effusion?

bloods
CXR/CT chest
ultrasound

brochoscopy

6

pleuritic chest pain just pleura?

nope, all organs around it, including muscles

7

breath sounds in air or fluid are?

reduced

8

what can mimic a pleural effusion?

raised hemi diaphragm

9

unilateral effusion cause?

pneumonia
primary lung cancers
Trauma
TB
post-PE
heart failure but less common

10

bilateral effusion cause?

heart failure
low-pressure states (low oncotic pressure)
malignancy d

11

what is a chylothorax?

lymph with chylomicrons effusions into

12

why do you get air in pleural space?

spontaneous (smoking, FHx, Marfan's)
trauma
underlying lung disease (COPD, lung bullae)

13

how to manage air in pleural space?

could resolve spontaneously
-drainage: aspiration, ICC with underwater seal (one way valve)

-pain relief, O2

14

why O2 speed up resolution of pneumothorax?

concentration gradient to push nitrogen out and O2 into tissues

15

chest tube has stopped swinging, why?

blocked lumen
kinked tube

Tube slipped into subcut or was never in the right space
Tube tap is in wrong spot.

16

when take out the tube?

no air leaks
recurrent

17

what is fluid in a CT pleural effusion that doesn't change with gravity?

loculated pleural fluid

18

what could cause loculated pleural fluid?

empyema

19

what to do with empyema?

drain it

20

when to intervene with tube? re: pH?

pH

21

chest tube size matter for empyema?

not really, but with loculated, use DNA-ase, tPA to break it down.

22

how pleuradhesive?

talc: active inflammation to stick
strip pleura

23

what causes pleural plaques?

asbestos exposure
previous empyema,
TB or blood in pleural space

24

mesothelioma uni or bilateral usually?

usu. unilateral?

25

pleural plaques turns into mesothelioma?

Nope, just increased risk

26

expiration passive or active?

passive usually