Flashcards in Pleurisy, Pleural Effusions, and Empyema Deck (50)
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1
What is pleurisy
Inflammation of the pleura
2
MC cause of pleural effusion in children
Bacterial pneumonia
3
Most common causes of pleural effusion in children second to bacterial pneumonia
1) Heart failure 2) Rheumatologic 3) Metastatic intrathoracic malignancy
4
Inflammatory processes in the pleura are divided into 3
1) Dry or plastic 2) Serofibrinous or serosanguinous 3) Purulent pleurisy or empyema
5
Etiologies of dry/plastic pleurisy
1) Bacterial or viral pulmonary infection 2) Acute URTI 3) Tb 4) Connective tissue disease (e.g. RF)
6
Principal symptom of dry/plastic pleurisy
Pain
7
In dry/plastic pleurisy, the child often lies on which side relative to the affected side
ON the affected side in an attempt to decrease respiratory excursions
8
A leathery, rough, inspiratory and expiratory friction rub may be heard in which phase of illness in cases of dry/plastic pleurisy
Early or late
9
T/F Patients with pleurisy and pneumonia should always be screened for Tb
T
10
T/F In pneumonia with pleural effusion, immobilization of the chest and cough suppressive drugs are indicated
F
11
T/F In pleural effusion without pneumonia, strapping of the chest to restrict expansion may afford relief
T
12
Which type of pleurisy is associated with inflammatory conditions of the abdomen or mediastinum
Serofibrinous/serosanguinous
13
Type of pleurisy associated with primary or metastatic neoplasms of the lung, pleura, or mediastinum
Serofibrinous/serosanguinous
14
Hemorrhagic pleurisy are usually associated with what condition
Tumors
15
Pleural fluid usually come from
Capillaries of the parietal pleura
16
Pleural fluid is absorbed by what structures
Pleural stomas and lymphatics of the parietal pleura
17
The rate of pleural fluid formation is dictated by what law
Starling Law
18
Normally, only ___mL fluid is present in the pleural space
4-12
19
Mechanism of pleural effusion formation in pleural inflammation
1) Increased pleural membrane permeability 2) Increase proteinaceous fluid formation 2) Lymphatic absorption obstruction
20
Serofibrinous pleurisy is often preceded by
Plastic pleurisy
21
PE finding particularly in infants with pleurisy
Bronchial breathing
22
Exudate: Protein level
>3 g/dL
23
Exudate: Pleural fluid:Serum protein ratio
>0.5
24
Exudate: Pleural fluid LDH
Less than 200 IU/L
25
Exudate: Pleural fluid: Serum LDH ratio
>0.6
26
Exudate: pH
Less than 7.2
27
Pleural fluid glucose level in malignancy, rheumatoid disease, and Tb
Less than 60 mg/dL
28
Pleural fluid exam finding of many small lymphocytes and pH less than 7.2 suggests what
Tuberculosis
29
SG of pleural fluid if it is a hydrothorax
Less than 1.015
30
