Pleural Pathology

Question 1

This is the excess fluid that accumulates between the 2 pleural layers and can impair breathing by limiting the expansion of the lungs

Answer 1

Pleural effusion

Question 2

What are the 4 causes of pleural effusions?

Answer 2

1. Block lymphatics
2. Heart failure
3. Greatly reduced colloid pressure
4. Infection

Question 3

What are the 3 types of inflammatory pleural effusions?

Answer 3

serous, serofibrinous, or firinous pleuritis

Question 4

What are the 5 CAUSES of inflammatory pleural effusions?

Answer 4

TB
PNA
Lung Infarcts
Lung Abscess
bronchiectasis

Question 5

Radiation can often lead to which type of inflammatory pleural effusion?

Answer 5

Serofibrinous pleuritits

Question 6

What typically causes purulent pleural exudate?

Answer 6

Bacterial or mycotic seeding of the pleural space.

Question 7

This is the collection of pus within the pleural space.

Answer 7

Empyema

Question 8

What is the composition of empyema in the pleural space?

Answer 8

Loculated, yellow-gree, creamy pus composed of masses of neutrophils with other leukocytes

Question 9

Hemorrhagic diseases, rickettsial disease, and neoplastic involvement typically result in what pleural condition?

Answer 9

Hemorrhagic diatheses

Question 10

This is a collection of serous fluid in the pleural cavity.

Answer 10

Hydrothorax

Question 11

Are hydrothorax, chylothorax, and hemothorax types of inflammatory or noninflammatory pleural effusion?

Answer 11

Noninflammatory

Question 12

What is the most common cause of hydrothroax?

Answer 12

Heart failure

Question 13

What causes hemothorax?

Answer 13

Ruptures aortic aneurysm or vascular trauma

Question 14

What causes chylothorax?

Answer 14

Typically thoracic duct trauma ir obstruction that causes lymph duct rupture (like malignancy)

Question 15

This is air or gas in the plaural space.

Answer 15

Pneumothorax

Question 16

This type of pneumothorax is typically from the rupture of a bleb, resulting in the collapse of the lung.

Answer 16

Spontaneous pneumothorax

Question 17

Where does the trachea shift in a spontaneous pneumothorax?

Answer 17

Towards the affected lung (Pathoma)

Question 18

True or False: spontaneous idiopathic pneumothorax usually subsides spontaneously as the air is reabsorbed.

Answer 18

True

Question 19

This is the type of pneumothorax when theres a defect int eh chest wall that permits entrance of air into the chest cavity but doesnt allow it to escape (like pumping up a basketball).

Answer 19

Tension pneumothorax

Question 20

Which way does the trachea shift in a tension pneumothorax?

Answer 20

AWAY from the affected lung

Question 21

Solitary fibrous tumors have what 2 lab values to distinguish it from mesotheliomas?

Answer 21

CD34+

Keratin (-)

Question 22

This is the type of mesothelioma where there is cuboidal, columnar, or flattened cells forming tubular or papillary structures.

Answer 22

Epitheloid type

Question 23

This is the type of mesothelioma where its a spindle cell sarcoma.

Answer 23

Sarcomatoid type

Question 24

What are the Sx for mesothelioma?

Answer 24

recurrent pleural effusions, chest pain, and dyspnea

Question 25

What % of people die from mesothelioma within 12 months of Dx?

Answer 25

50%

Question 26

End stage emphysema, idiopathic pulmonary fibrosis, cystic fibrosis, and idiopathic/familial pulmonary arterial hypertension are all candidates for what?

Answer 26

Lung transplant

Question 27

Why is it easy to get a pulmonary infection in a lung transplant?

Answer 27

The recipient is immunosupressed

Question 28

What do u see on transbronchial biopsy for acute rejection on lung transplant?

Answer 28

Lymphocytes, plasma cells, and few neutrophils and eosinophils either aroudn small vessels in the submucosa of airways or both.

Question 29

What is a significant problem in at least 1/2 of all lung transplant pts by 3-5 years?

Answer 29

Chronic rejection

Question 30

What is the morphology of the lung in chronic rejections?

Answer 30

Bronchiolitis obliterans, the partial or complete occlusion of small airways by fibrosis, with or without active inflammation.

Question 31

This is the form of pleural effusion where there is high protein, high cholesterol, and high pleural LDH (>0.6 relative to plasma).

Answer 31

Exudate

Question 32

What is the most common cause of a transudative pleural effusion?

Answer 32

congestive heart failure

Question 33

What si the most common cause of an exudative pleural effusion?

Answer 33

PNA

Question 34

This is the turbid or milky white fluid with chylomicrons, and caused by the 5 T’s (thoracic duct trauma, tumor, TB, and Tuberous sclerosis).

Answer 34

Chylous effusion