[pleural effusion] Flashcards
(66 cards)
1
Q
A
transudate
exudate
2
Q
A
transudate
exudate
3
Q
A
4
Q
A
> 35g/L protein
5
Q
A
pus in the pleural space
6
Q
A
blood in the pleural space
7
Q
A
air in the pleural space
8
Q
A
lymph + fat in the pleural space
9
Q
A
haemopneumothorax
10
Q
A
trans - across (from blood = low protein)
Ex - extra protein - excreted from infection
11
Q
A
increased venous pressure
hypoalbuminaemia
hypothyroidism
Meig’s syndrome
12
Q
A
right pleural effusion
ovarian fibroma
ascites
(transdiaphragmatic lymphatic channels are larger in diameter on the right = effusion on right)
13
Q
A
increased permeability of pleural capillaries due to infection/malignancy
14
Q
A
malignancy (carcinoma/metastases)
infection (TB/pneumonia)
pulmonary infarction
systemic inflammatory disorders (SLE/RA)
15
Q
A
16
Q
A
> 35g/L protein
17
Q
A
pus in the pleural space
18
Q
A
blood in the pleural space
19
Q
A
air in the pleural space
20
Q
A
lymph + fat in the pleural space
21
Q
A
haemopneumothorax
22
Q
A
trans - across (from blood = low protein)
Ex - extra protein - excreted from infection
23
Q
A
increased venous pressure
hypoalbuminaemia
hypothyroidism
Meig’s syndrome
24
Q
A
right pleural effusion
ovarian fibroma
ascites
(transdiaphragmatic lymphatic channels are larger in diameter on the right = effusion on right)
25
[pleural effusion]: what causes transudate leakage
increased permeability of pleural capillaries due to infection/malignancy
26
[pleural effusion]: give 4 causes of exudative pleural effusions
malignancy (carcinoma/metastases)
infection (TB/pneumonia)
pulmonary infarction
systemic inflammatory disorders (SLE/RA)
27
[pleural effusion]: define a transudate effusion
28
[pleural effusion]: give 4 causes of exudative pleural effusions (4)
malignancy (carcinoma/metastases)
infection (TB/pneumonia)
pulmonary infarction
systemic inflammatory disorders (SLE/RA)
29
[pleural effusion]: although it can be asymptomatic what are the 2 symptoms if present? (2)
Pleuritic chest pain
| dyspnoea
30
[pleural effusion]: what is the ∆∆
tension pneumothorax
31
[pleural effusion]: what signs may be present
stony dull percussion
diminished breath sounds
tracheal deviation away (in large effusions)
bronchial breathing ABOVE the effusion
32
[pleural effusion]: what is bronchial breathing
expiration phase as long or longer than inspiration
harsh blowing quality
high pitched sounds not filtered out
33
[pleural effusion]: what is bronchial breathing (3)
expiration phase as long or longer than inspiration
harsh blowing quality
high pitched sounds not filtered out
34
[pleural effusion]: why is there bronchial breathing above the effusion
compression of lung
35
[pleural effusion]: what is the difference between pleural effusion and oedema on CXR
effusion has a meniscus
36
[pleural effusion]: what is the 1st Ix
CXR
37
[pleural effusion]: what would be seen on CXR
blunting of costophrenic angles
38
[pleural effusion]: if there is a completely flat horizontal upper border what does this imply?
pleural effusion + pneumothorax
39
[pleural effusion]: what is the difference between pleural effusion and oedema on CXR
effusion has the appearance of a meniscus (actually lung pushing fluid up side)
40
[pleural effusion]: if there is a completely flat horizontal upper border what does this imply?
pleural effusion + pneumothorax
| lung no long pushing fluid up side = no meniscus look
41
[pleural effusion]: if there is a completely flat horizontal upper border what does this imply?
pleural effusion + pneumothorax
| lung no long pushing fluid up side = no meniscus look
42
[pleural effusion]: What is the golden 1st Ix for identifying the cause of the pleural effusion
diagnostic aspiration
| 1-2 intercostal spaces below effusion - percuss - 21 gauge
43
[pleural effusion]: what is the 2nd line Ix for identifying the cause of the pleural effusion (if 1st line unsuccessful)
Pareital pleura biopsy
44
[pleural effusion]: what appearance do trans and exudative pleural fluids have (2)
clear
| straw coloured
45
[pleural effusion]: what appearance do empyemas have (2)
turbid
| yellow
46
[pleural effusion]: what may cause a haemorrhagic gross appearance of pleural fluid
trauma
malignancy
pulmonary infarction
47
[pleural effusion]: what may cause a haemorrhagic gross appearance of pleural fluid
trauma
malignancy
pulmonary infarction
48
[pleural effusion]: what disease would you suspect if pleural fluid contained lupus erythematous cells
SLE
49
[pleural effusion]: what disease would you suspect if pleural fluid contained multinucleated giant cells
RA
50
[pleural effusion]: what disease would you suspect if pleural fluid contained abnormal mesothelial cells
mesothelioma
51
[pleural effusion]: what disease would you suspect if pleural fluid contained increased mesothelial cells
pulmonary infarction
52
[pleural effusion]: what disease would you suspect if pleural fluid contained increased mesothelial cells
pulmonary infarction
53
[pleural effusion]: what disease would you suspect if pleural fluid contained increased lymphocytes (5)
```
malignancy
sarcoidosis
TB
RA
SLE
```
54
[pleural effusion]: what disease would you suspect if pleural fluid contained increased neutrophils
pulmonary embolism
55
[pleural effusion]: what disease would you suspect if pleural fluid contained amylase (4)
oesophageal rupture
pancreatitis
bacterial pneumonia
carcinoma
56
[pleural effusion]: what disease would you suspect if pleural fluid contained rheumatoid factor
RA
57
[pleural effusion]: what disease would you suspect if pleural fluid contained antinuclear Ab
SLE
58
[pleural effusion]: what disease would you suspect if pleural fluid contained low glucose, low pH raised LDH (5)
```
empyema
malignancy
TB
RA
SLE
```
59
[pleural effusion]: what disease would you suspect if pleural fluid contained low glucose, low pH raised LDH (5)
```
empyema
malignancy
TB
RA
SLE
```
60
[pleural effusion]: Mx: 1st line Tx
chest drainage
| US supervision - safe triangle - not where pneumothorax goes
61
[pleural effusion]: Mx: what are the intercostal ribs involved in the safe triangle
4-6th
| anterior to mid clavicular line
62
[pleural effusion]: what is a chylothorax
lymph + fat in the pleural space aka chyle
63
[pleural effusion]: Mx: what are the intercostal ribs involved in the safe triangle
4-6th
| anterior to mid clavicular line
64
[pleural effusion]: Mx: if recurrent effusions what may help?
pleurodesis (artificial destruction of pleural space - sticks the 2 pleural layers together)
65
[pleural effusion]: Mx: if recurrent effusions what may help?
pleurodesis (artificial destruction of pleural space - sticks the 2 pleural layers together)
66
[pleural effusion]: if the protein content is between 25 and 35 how can you determine between exudate and transudate
pleural protein: serum protein
if ratio >0.5 effusion is exudate
