compressive vs obstructive atelectasis
Tags & Description
compressive vs obstructive atelectasis
compressive has increased tactile fremitus
tactile fremitus in pneumonia vs pleural effusion
pneumonia - increased effusion - decreased
a solitary pul nodule w/ mediastinum widening and atelectasis is seen in which patho
lung cancer
why do we percuss supraclavicular area
Pancoast Tobias tumour (apical lung)
trousseau's syndrome occurs in which patho
lung cancer (vascular syndrome)
neurologic syndromes from lung cancer
eaton-lambert
endocrine syndromes from lung cancer
hypercalcemia, oliguria, Cushing
when is there hoarseness in lung cancer
laryngeal n paralysis from left side tumour
manifestations of lung cancer
asymptomatic
non specific (weight loss, anemia)
pul lesion -> cough, hemoptysis, dsypnea, wheeze, atelectasis
intrathoracic spread -> dysphagia, hiccups, horner's, pleural effusion
extrathoracic spread -> bone, liver, adrenal, brain
paraneoplastic syndrome
lung cancer is divided into
NSCLC (adeno, squamous + large cell carcinoma) and SCLC
risk factors for lung cancer
smoking, carcinogens, copd, women who smoke, black men, HIV, inheritance
ECG w/ increase S1 and T3 pattern is indicate of which patho
pul embolism
signs of pul embolism on xray
Westermark (dilation of pul vessel), Hampton hump (triangular infiltrate)
physical exam in pul embolism
unilateral leg swell, tachycardia, hypotension, consolidation signs of lungs, d-dimer
symptoms of pul embolism
pleuritis chest pain, hemoptysis, back + shoulder + upper abd pain
consequences of pul embolism are primarily
hemodynamic (emboli, resp insufficiency)
patient-related predisoping factors of pul embolism
age, history of prevout VTE, cancer, major surgery, MI, estrogen use
hereditaroy factors for v thromboemebolism are those related to
thrombophilia (AT3, protein C, S)
etiology of pul embolism
DVT -> thromboembolism
DD bw abscess and lobar pneumonia
coarse crackles in abscess
physical findings of lung asbcess
clubbing, consolidation sounds (coarse crackles, decreased sounds), pleural rub
manifestations of lung asbcess
chill, low fever, foul smell sputum, hemoptysis, dyspnea, night sweats
classifcation of lung abscess
primary by aspiration secondary by bronchiectasis, immunocompromised or tumour
patients with mouth diseases, seizures and dysphagia + impaired consciousness are at higher risk of what
lung abscess
pleural effusion
collection of fluid in pleural linings
causes of pleural effusion
congestive hf, malignancy, infections and pul emboli
transudate vs exudate pleural effusion
manifestations of pleural effusion
unilateral + sharp pain, worsens w/ inspiration and cough dyspnea dry cough
xray of pleural effusion
hemidiaphragm elevated
thoracentesis
removal fluid from pleural effusion, diagnostic or therapeutic
therapeutic thoracentesis (+limit)
removes larger amounts pleural effusion to alleviate dyspnea, max 1500ml
putrid odor pleural fluid in effusion suggests
anaerobic empyema
ammonia odor pleural fluid in effusion suggests
urinothorax
black pleural fluid in effusion suggests
aspergillosis
yellow/green pleural fluid in effusion suggests
rheumatoid pleural effusion
bloody pleural fluid in effusion suggests
trauma, malignancy, high amounts is hemothorax
when is pleural effusion considered an exudate
high protein and LDH
pleural fluid ldh levels >1000 IU/L suggests
empyema, malignant effusion or rheumatoid effusion
low pleural fluid glucose in effusion suggests
malignancy, TB or empyema
how to test for TB pleural effusion
acid-fast bacillus stain or ADA (adenosine deaminase)
high triglycerides, chol and milky pleural fluids suggests
chylothorax
in patients with pleural effusion, bronchoscopy is only done when
patient has parenchymal abnormalities or hemopytsis
causes of pleural transudate effusions
congestive heart failure, cirrhosis, nephrotic syndrome
congestive HF causing pleural transudate effusions
biventricular failure causing bilateral effusions, also called hydrothorax
forms of pleural exudative effusions caused by infections
parapneumonic effusion
uncomplicated (pneumonia)
complicated (bacteria, increased neutrophils)
empyema (loculated pus)
causes of empyema
trauma, lung abscess rupture, septic infarction, infection, esophageal rupture
manifestations of parapneumonic effusions
symptoms of effusion (pain, dyspnea, dry cough) with fever
anaerobic bacterial parapneumonic effusion manifestation
weight loss
physical exam of pleural effusion
febrile, tachypnea, tachycardia (looks like SIRS), diaphragm in upper position, dullness, decreased breath sounds + fremitus, tracheal shift