Lecture 8 Pleural Effusion (missed lecture) Flashcards Preview

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Flashcards in Lecture 8 Pleural Effusion (missed lecture) Deck (24):
1

Normal pleural fluid:
pH is (acidic or alkaline); most cells are _____, there are no ____ typically

alkaline (7.6); MQ, no PMNs

2

pleural fluid is produced by the ____ pleura and absorbed by the ___ pleura. the pleural space should be virtually ____ free

parietal, visceral;
fluid

3

fluid accumulates in the pleural space by 3 mechanisms:
increased ____ of fluid into the space, increased production of fluid by ____ in the space, decreased ____ of fluid from the space

drainage, cells; drainage

4

at FRC, the intrapleural pressure is ____, preventing _____

negative, pneumothorax

5

development of pleural effusion:
____ pulmonary capillary pressure such as CHF;
increased capillary permeability such as in ____;
____ intrapleural pressure such as in atelectasis

increased,
pneumonia,
increased

6

development of pleural effusion:
____ plasma oncotic pressure such as nephrotic syndrome,

decreased

7

a chylothorax is due to ____ injury from trauma or malignancy. there is a large amount of _____. a pseudochylothorax has a high amount of ___

throacic duct; triglycerides (ie greater than 110); cholesterol (ie greater than 250)

8

transudate vs exudate:
which has a high protein count?
which is cloudy?
which us usually bilateral?
which occurs in states of increased vascular perm?

exudate, exudate, transudate, exudate

9

malignancy, pneumonia, collagen vascular disease, pancreatitis, and trauma all cause an ____ effusion

exudate

10

causes of transudative effusion: hepatic ____, _____, ____ syndrome

cirhossis, CHF, nephrotic

11

with pleural effusion, there is restricted lung ____ during ____. On physical exam, there is ____ to percussion, ____ tactile fremitus, ____ breath sounds, and _____.

expansion, inspiration;
dullness, decreased, decreasedd egophony

12

CXR shows blunted _____ angles. what position is most sensitive for CXR?

costophrenic;
lateral decubitus

13

fluid in CXR is seen as a dense ___ shadow with a ____ upper edge

white; concave

14

in atelectasis, the heart and mediastinum are shifted ____ the whited out hemithorax. in a massive pleural effusion, the heart and mediastinum are shifted ____ the whited out hemithorax

toward; away from

15

in thoracentesis, the needle should be inserted through the ____ border of the ____ rib

upper, lower

16

pleural fluid lactate dehydrogenase: serum LDH ratio:

in ____ it is less than 0.6. in ____, it is greater than 0.6

transudate; exudate;

ie exudate has increased LDH.

17

in an empeyema pleural effusion, pH is ____ and gluocse concentration is ____

reduced (ie acidic), reduced

18

What other condition usually causes a low gluocse concentration in the pleural fluid?

rheumatoid pleurisy

(also malignancy, Tb)

19

lactate levels are significantly higher in ____ and ____ pleural effusions than in other pleural effusions

bacteria, Tb

20

pleural effusions with elevated amylase typically indicate ____, ____ rupture, or malignancy

pancreatitis, esophageal

21

pleural effusions:
high Adenosine deaminase usually indicates ____;
high interferon gamma usually indicates ____

Tb, Tb pleuritis

22

markedly increased numbers of mesothelial cells + blood or eiosinophillic effusions suggests _____ as the cause of effusion

pulmonary embolism

23

a pleural biospy is most helpful in evaluating for ____.

Tb;

also maybe sarcoid, fungal

24

3 stages of empyema:

exudative (1-3 days), fibrinopurulent (4-14 days), organizational (after 14 days)