541 - Pleural Disease + Spirometry + Pulmonary pre/post op

Which condition is characterized by the accumulation of fluid in the pleural space due to the manifestation of underlying disease?

pleural effusion

1 multiple choice option

What are the 3 most common sx of pleural effusions?

-dyspnea

-cough

-pleuritic CP

pleural effusion etiology:

↑ pleural membrane permeability

↓ intrapleural pressure

↓ capillary oncotic pressure

pleural effusion exudates (at least 1 must be present):

-pleural fluid protein > 0.5

-pleural LDH > 0.6

-pleural fluid LDH > 2/3rds upper limits of lab's normal LDH

Pleural effusion sx tx:

large-vol thoracentesis

and/or

pleural drain

Pleural effusion asx tx:

tube thoracostomy/pleural intervention not required. Followed every 3-6 weeks for observation.

Which condition is characterized by an abnormal collection of gas, usually air, in the pleural space and subsequent collapse of the lung (typically due to trauma or spontaneous rupture)?

pneumothorax

1 multiple choice option

Which form of pneumothorax has known precipitating factors?

nonspontaneous (traumatic & iatrogenic)

1 multiple choice option

Which form of pneumothorax has no obvious precipitating factors?

spontaneous (primary & secondary)

1 multiple choice option

Which imaging is the dx study for primary spontaneous pneumothorax?

CT

3 multiple choice options

Unstable pts with a clinical high suspicion of a pneumothorax require needle decompression or tube thoracotomy ________ imaging

before

2 multiple choice options

Which condition is characterized by sharp pain that worsens w/ deep breathing?

pleuritic chest pain

What is the most common cause of pleuritic chest pain?

viral infections

What is the tx for pleuritic CP?

NSAIDs

↳corticosteroids if intolerant

Recurrent cases of pleuritic CP is most likely to occur with:

-malignancy

-renal failure

-pleurisy

The measurement of the ease of transfer for CO molecules from alveolar gas to the hemoglobin of the RBCs in the pulmonary circulation is known as

DLCO2

If an FEV1/FVC result is < 70% of predicted, it is considered to be

obstructive

2 multiple choice options

If an FEV1/FVC result is > 70% of predicted, each measurement must be looked at individually. If the FVC and the FEV1 results are both < 80%, then it is considered to be

restrictive

2 multiple choice options

If an FEV1/FVC and FVC are both decreased (below 80%) then it is considered to be

mixed

2 multiple choice options

What are the 3 most commonly used pre-anesthetic medications?

benzo

melatonin

doperidol/decadron

Which scale scores for postoperative pulmonary complications?

ARISCAT