Dyspnea Flashcards
(31 cards)
What type of lung cancer is linked to asbsestos
Mesothelioma
Which lung cancers are centrally located
neuroendocrine, large cell, squamous
Where are adenocarcinomas located
Peripheral, arise from terminal bronchioles,
From mucous glands
Lung cancer diagnosis
- CT scan
- CT guided biopsy of nodules
- Fine needle aspiration (FNA) of palpable LNs
- Bronchoscopy (EBUS, endobronchial ultrasound)
- Serum tumor markers are useless
Risk of malignancy when lung nodules are found incidentally
- Age >30-50
- Smoker
- Prior malignancy
- Irregular boarders, calcification
- Solitary metastisis to lung occurs also in melanoma, sarcoma, or testicular cancer
Which cancers commonly metastisize to the lung
melanoma, sarcoma, or testicular cancer
Lung cancer staging
1-2 are cured with surgery
3a may benifit from surgery
3b and 4 do not benifit from surgery
What is staging for SCLC
No staging, no TN< staging because metastases are assumed,. Poor progrnosis, median length of survivial is 6%
Current screening for lung cancer
CT yearly for past smokers 50-80 with 20 pack year hx (active smoker or quit in last 15 years)
What is the most common pleural disease
pleural effusion
Why does pleural effusion occur
- Increase in pleural fluid formation
- Decrease in pleural fluid clerance
Transudative vs exudate
Transudative- increased hydrostatic or decreased oncotic pressures NORMAL CAPILLARIES
Exudate- increased production of fluid from ABNORMAL capillary permeability from inflammation
Decreased Lymph clerance (Malignancy)
Decreased lymph clerance from malignancy leading to a pleural effusion is transudative or exudative
exudative
Abnormal capillary permiability from inflammation
Infection of pleural space
empyema
bleeding into pleural space
hemothorax
Causes of exudative pleural effusions
Pneumonia, cancer, TB, viral infection cause
Causes of transudative Pleural effusions
Cirrhosis, CHF, nephrotic, PE
What type of pleural effusion does PE cause
Both transudative or exudative
Pleural effusion presentation
Asymptomatic
Dyspnea
Cough
Pleuritic chest pain
When do you do a small volume aspiration of a pleural effusion
for diagnostic purposes when unilateral or when cause is unknown
When to do large volume aspiration in pleural effusion
Dyspnea
When to do Thoracentesis
- Fever, pleuretic chest pain, no response to loop diuretic
- Dyspnea
- Remove 1500 cc fluid at one time or LESS, more leads to pulmonary edema
Thoracentesis is straw colored fluid
Transudative
Thoracentesis is thick and cloudy
High levels of protein, exudative
