Pleural Diseases Flashcards Preview

Respiratory > Pleural Diseases > Flashcards

Flashcards in Pleural Diseases Deck (41):
1

What does the parietal pleura cover?

Rib cage
Mediastinum
Diaphragm

2

What pulls the the visceral pleura inward?

Lungs elastic recoil

3

What pulls the parietal pleura outward?

Chest wall

4

Which way does the fluid flow in the pleural space? How much flows through here?

From the parietal pleura to the pleural space

5-10L

5

What are the two types of pleural effusions?

Transudative
Exudative

6

What are the two types of pneumothorax?

Spontaneous
Traumatic

7

What are the symptoms of a pleural effusion?

Cough
SOB
Pleuritic chest pain

8

What are the signs of a pleural effusion?

Hypoxia
Tachypnea
Dullness to percussion

9

What type of breath sounds are predominant with a pleural effusion?

Bronchial

10

What happens to the mediastinum with a pleural effusion?

Shifts away from the lung

11

What are the CXR findings of a pleural effusion?

-Dense lung opacification
-Blunting of the costophrenic angle
-Lung shifted upward

12

What is the best position for the patient to be in to detect a pleural effusion?

Left lateral decubitus

13

How helpful is a gross examination of pleural fluid?

Rarely helpful unless bloody or chylous

14

Why are pleural effusions smelly?

Anaerobic infections

15

What is examined with a thoracentesis?

-WBC
-pH
-Glucose
-Protein
-LDH
-Cultures

16

What is the pleural fluid/serum protein level for exudate?

Greater than 0.5

17

What is the pleural fluid/serum LDH level for exudate?

Greater than 0.6

18

What are the causes of transudate? (4)

CHF
PE
Cirrhosis
Nephrotic syndrome

(anything that decreases oncotic pressure, or increases hydrostatic pressure)

19

What are the causes of exudate? (4)

Tumor
Infection
Trauma
Inflammation

20

What is the pleural fluid analysis reveal for a pleural fluid?

pH less than 7.2

21

What can cause an increase in amylase in pleural fluid?

Pancreatitis
Esophageal rupture

22

What is the treatment for an empyema with a low pH (less than 7.2)?

Chest tube

23

What does a decreased glucose level in pleural fluid indicate?

Infection or neoplasm

24

What is a cholesterol effusion?

Presence of cholesterol crystals in pleural fluid caused by long standing chronic pleural effusions

25

What usually causes a chylothorax?

Milky effusion that has high lipid content, usually caused by trauma or neoplastic process

26

What is the pleural fluid HCT/Serum HCT of a hemothorax?

Greater than 0.5

27

What is chemical pleurodesis?

Administration of a sclerosing agent, irritant into the pleural space

28

What is the indication for a chemical pleurodesis?

Recurrent pleural effusions which initially responded to simple thoracentesis

29

What is usually used to a chemical pleurodesis?

Talc powder
Doxycycline

30

What is the indication for a pleural biopsy?

Persistent pleural effusions, especially when TB is suspected

31

What are the ssx of a pneumothorax?

SOB
Chest pain
Cough

32

What happens to the mediastinum with a pneumothorax?

Shifts toward unless tension, then away

33

When is a thoracostomy tube indicated for a pneumothorax?

Greater than 50%

34

What are the causes of pneumothorax?

-Emphysema
-ILD
-Eosinophilic granuloma
-CF
-Asthma
-Malignancy

35

What type of workup should be done in a patient with a new onset pneumothorax, without explainable cause?

Malignancy

36

What are the idiopathic causes of a pneumothorax?

-esophageal perforation
-Mechanical ventilation

37

What is mesothelioma?

Benign or malignant growths in the plural space d/t asbestos exposure

38

What are the common tumors that invade the pleural space?

Bronchogenic or carcinoma

39

What is type of pleural effusion is seen with malignancy?

Blood

40

What are the drugs that can cause SLE induced pleural disease?

INH
Procainamide
Hydralazine

41

What type of virus can cause pleural disease?

Coxsackie