Pulm Pleural Disorders Flashcards
(34 cards)
What is pleural effusion?
abnormal accumulation of fluid in the pleural space (more than 5ml)
What are the types of pleural fluid?
1) transudate
2) exudate
3) empyema
4) hemothorax
What is transudate?
- there are normal capillaries (there is NO inflammation) but hydrostatic pressure is increased b/c pressure from the heart failure backs up into the lungs and the pressure cxs the fluid to leak out into the pleural space
- also cxs decrease in oncotic pressure b/c there is pressure on the vessels
- chemistries will show lower than 0.5
- LDH will be lower than 0.6
What is exudate?
- there is vasodialation b/c of inflammation so the vessels are bigger cxing BOTH fluid and proteins to get pushed out
- there is decreased lympathic clearance b/c of lymphatic obstruction
- chemistries will show higher than 0.5 b/c the cell contents are increased
- LDH will be higher than 0.6
What is empyema?
infxn in the pleural space giving off PUS
What is hemothorax?
bleeding into the pleural space
What is Parapneumonic effusion?
exudates d/t bacterial pneumonia
Labs for Pleural effusion?
- throacentesis (light’s criteral) to figure out if fluid is exudate or transudate
- CXR: displaced diaphragm
- US: lungs are “floating” b/c denser than water
Labs for transudate?
-clear
Labs for exudate?
-white
Labs for hemothorax?
-bloody
Tx for pleural effusion?
- Malignancy (exudate): refer
- Parapneumonic: supportive
- Hemothorax: drain
What is pneumothorax?
accumulation of air in the pleural space
What are the types of pneumothorax?
- spontaneous (primary and secondary)
- traumatic
- iatrogenic
- tension
What is spontaneous primary pneumothorax?
- no lung dz before
- occurs in males 10-30 yo (d/t growth spurt / smoking)
- may have family hx
What is spontaneous secondary pneumothorax?
- lung dz
- complication of COPD
- asthma
- P jiroveci
- at higher risk of COPD/asthma
What are sx/PE of pneumothorax?
- chest pains
- BIG: decrease tactile fremitus; decrease of chest movement; tachycardia; tracheal shift TOWARDS affected lung
- TENSION: increase x2 in tachycardia, hypotension, tracheal shift AWAY from affect lung
What is tension pneumothorax?
-air enters pleural space but cannot get out d/t (1) trauma (2) lung infxn
CXR on pneumothorax?
pleural lines
Complications on pneumothorax?
- pneumomediastinum: ruptured esophagus/bronchus - able to FEEL crackles via subcutaneous emphysema
- TENSION: can lead to death
Tx of pneumothorax?
- small: observe w/O2
- large: small catheter aspiration w/ serial xrays q24 hrs
- severe: thoracostomy
- pt education: STOP SMOKING; avoid flying unpressurized aircraft, high latitudes, scuba diving
- recurrent/failure of first tube: thorascoscopy/open thoractomy
What is sleep apnea?
pause in breathing for more than 10 seconds with lower than 90% O2 stats
What are the types of sleep apnea?
- obstructive sleep apnea
- central sleep apnea
What is obstructive sleep apnea?
PHYSICALLY obstruction of the airway
