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Flashcards in pleural disease Deck (24)
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1

what is pleural effusion?

abnormal collection of fluid in the pleural space
- do a pleural tap

2

what does straw coloured fluid mean?

cardiac failure
hypoalbuminaemia

3

what does bloody coloured fluid mean?

trauma
malignancy
infection
infarction

4

what does turbid/milky ocloured fluid mean?

empyema
chylothorax

5

what does foul smelling fluid mean?

anaerobic empyema

6

what do food particles in the fluid mean?

oesophageal rupture

7

transudates?

proteins < 30 g/L
heart failure
liver cirrhosis

8

exudates?

proteins > 30 g/L
malignancy
infection inc TB

9

fluid pH

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

10

when is gluocse low?

in infection
TB
rheumatoid arthirisis
malignancy
oesophagela rupture
SLE

11

when is amylase raised?

in pancreatitis and oesophageal rupture

12

when is creatine raised?

in urinothroax

13

when is adenosine deaminase raised?

in TB

14

what are the effects of systematic tumours?

embolism
hypoalbuminaemia

15

what are the effects of local tumours?

post obstructive infection
lymphatic obstruction
atelectasis

16

what is mesothelioma?

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

what is asbestos?

- chrysotile = white = most common
- amosite = brown
- crocidolite = most dangerous

18

what is the treatment for mesothelioma?

- pleurodese effusion
- radiotherapy
- surgery
- chemotherapy
- paliative care

19

what is a long term pleural catheter?

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

20

how do you treat effusions?

- LVF = diuretics
- infection = drian, antibiotics, may require surgery
- malignancy = drain, pleurodesis, long term pleural catheter

21

what is the presentation of pneumothorax?

- tachycardia
- hyper-resonant pecussion note
- reduced expansion
- quiet breath sounds on auscultation

22

how do you manage pneumothorax?

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

23

do you give gentimycin for pleural infections?

no, avoid intra-pleural antibiotics

24

what do you give for pleural infection?

6 week course of co-amoxiclav