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Flashcards in Pleural Diseases Deck (13):
1

What are the Clinical Presentations of a Pleural Effusion?

Cough
Dyspnia
Nonspecific Discomfort
Occasional Pleuritic Chest pain

2

What are the physical findings of a pleural effusion?

Hypoxia
Tachypnia
Dullness on percussion
Decreased Breath Sounds
Bronchial Breathing
Mediastinal Shift

3

What are the steps of evaluation of pleural fluid?

Gross visual exam
Olfactory exam
Serologic Exam
Send out for WBC w/differential
Cell count
Glucose
Protein
LDH
Cultures/Gram stain
Amylase
Cytology

4

What are the parameters of a Transudate?

Pleural fluid protein/serum protein

5

What are the parameters of a Exudate?

Pleural fluid protein/serum protein >0.5
Pleural fluid LDH/Serum LDH >0.6
Pleural fluid LDH >0.45 normal serum

6

What are Causes of Transudates vs exudates

Trans: Hydrostatic or osmotic pressure; CHF, PE, cirrhosis, nephrotic synd, hypoalbuminemia
Exudates: Protein Rich; Tumor, infection, trauma, inflammatory conditions.

7

What is an empyema?

***pH

8

What are other factors in Analysis of pleural fluid?

Amylase
Decreased glucose?
Cholesterol effusion
Chylothorax
Hemothorax

9

What is Chemical Pleurodesis?

Administration of a sclerosing agent or irritant to "glue" the lung to the pleural wall.

10

What are the treatment options in pneumothorax?

Nothing(wait and watch)
Drainage by tube thoracostomy.
(may need to maintain suction for days!)

11

What is the tumor/cancer associated with the pleural space?

Mesothelioma associated with Asbestos exposure
Can be benign or aggressive or malignant

12

What are common causes of spontaneous Pneumothorax?

Iodiopathic
Emphysema
Interstitial Lung disease
Eosinophilic granuloma/ histeocytosis X
Cystic Fibrosis
Asthma
Malignancy

13

What are common causes of Traumatic Pneumothorax?

Penetrating and non-penetrating chest trauma
Transbronchoscopic or transthoracic lung biopsy
thoracentesis
Mechanical ventilation
Esophageal perforation