procedures + findings Flashcards
causes bilateral hilar lymphadenopathy
sarcoid + TB!!! // lymphoma, pneumoconiosis, fungi
cardiac causes clubbing
cyanotic congenital heart disease (tof, transposition) // endocarditis // atrial myxoma
resp causes clubbing
lung cancer // CF, bronchiectasis, abscess // TB // asbestosis,
systemic causes clubbing
crohns // cirrhosis // graves
causes chronic SOB
HF // asthma // aortic stenosis // fibrosis // cancer // bronchiectasis // anaemia // obese
indication chest drain
effusion +/- empyema // pneum/ heamothorax
contraindication chest drain
INR >1.3 // platelets <75 // bullae // pleural adhesions
where is chest drain inserted
patient at 45o // USS –> local lidocaine –> 5th intercostal midaxillarly line –> fix with stitch (seldinger technique)
how is position of chest tube confirmed
CXR - swinging fluid on inspiration
complication chest drain
failure // bleeding // infection // damage lung // re-expansion of pulm oedema
how does re-expansion of pulm oedema occur
too rapidly draining fluid –> SOB + COUGH
mx re-expansion of pulm oedema
clamp drain –> CXR
removing chest drain
effusion = if no output for >24 hours + imaging // pneumothorax = no more bubbling + imaging
safety triangle for chest drain insertion
Anterior edge latissimus dorsi // lateral border of pectoralis major // line superior to the horizontal level of the nipple // and the apex below the axilla.
causes cavitating lung lesions CXR
abscess (staph A, kleb, pseudomona) / squamous lung cancer // TB // GPA // PE // RA // aspergillosis
causes white lung lesions
consolidation // effusion // collapse // pneumonoectomy // pulm oedema
white lesion with trachea pulled towards it
(other lung pushing it towards it) // pneumonectomy // lung collapse // hypoplasia
white lesion with trachea pushed away from it
pleural effusion // diaphragmatic hernia // mass
whit lesion + central trachea
consolidation, pulm oedema mesothlioma
CXR pulmonary oedema
oedena // bats wing // upper lobe diversion // kerley B lines // effusion // cardiomegaly
causes lobar collapse
cancer // asthma // foeign body
CXR lobar collapse
trachea towards side of collapse // mediastinum towards sign of collapse // raised hemidiaphragm
causes medastinum widening
aortica aneurysm // lymphoma // goitre // teratoma // thyoma
common lung mets
breast // renal // colorectal // prostate // bladder // (Breathing Really beComes Pretty Bad)
