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Flashcards in pleural disease Deck (24)
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1
Q

what is pleural effusion?

A

abnormal collection of fluid in the pleural space

- do a pleural tap

2
Q

what does straw coloured fluid mean?

A

cardiac failure

hypoalbuminaemia

3
Q

what does bloody coloured fluid mean?

A

trauma
malignancy
infection
infarction

4
Q

what does turbid/milky ocloured fluid mean?

A

empyema

chylothorax

5
Q

what does foul smelling fluid mean?

A

anaerobic empyema

6
Q

what do food particles in the fluid mean?

A

oesophageal rupture

7
Q

transudates?

A

proteins < 30 g/L
heart failure
liver cirrhosis

8
Q

exudates?

A

proteins > 30 g/L
malignancy
infection inc TB

9
Q

fluid pH

A

normal = 7.6
< 7.3 = pleural inflammatoin
< 7.2 = requires drainage in the setting of infection

10
Q

when is gluocse low?

A
in infection
TB
rheumatoid arthirisis 
malignancy
oesophagela rupture
SLE
11
Q

when is amylase raised?

A

in pancreatitis and oesophageal rupture

12
Q

when is creatine raised?

A

in urinothroax

13
Q

when is adenosine deaminase raised?

A

in TB

14
Q

what are the effects of systematic tumours?

A

embolism

hypoalbuminaemia

15
Q

what are the effects of local tumours?

A

post obstructive infection
lymphatic obstruction
atelectasis

16
Q

what is mesothelioma?

A

uncommon malignant tumour in the lining of the lung or very occasionally in the lining of the abdominal cavity

  • as a result of asbestos
  • may causes breathlessness, chest pain, weight loss, fever, sweating and coughing
17
Q

what is asbestos?

A
  • chrysotile = white = most common
  • amosite = brown
  • crocidolite = most dangerous
18
Q

what is the treatment for mesothelioma?

A
  • pleurodese effusion
  • radiotherapy
  • surgery
  • chemotherapy
  • paliative care
19
Q

what is a long term pleural catheter?

A
  • designed to allow patients to control their effusion and symptoms
  • designed to remain in place for life
  • complications: incorrect placement, bleeding, infection
20
Q

how do you treat effusions?

A
  • LVF = diuretics
  • infection = drian, antibiotics, may require surgery
  • malignancy = drain, pleurodesis, long term pleural catheter
21
Q

what is the presentation of pneumothorax?

A
  • tachycardia
  • hyper-resonant pecussion note
  • reduced expansion
  • quiet breath sounds on auscultation
22
Q

how do you manage pneumothorax?

A
<2cm = oxygen
>2cm = high flow O2, aspirate via 16-18g cannula
23
Q

do you give gentimycin for pleural infections?

A

no, avoid intra-pleural antibiotics

24
Q

what do you give for pleural infection?

A

6 week course of co-amoxiclav