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04 Pleural and Pericardial Diseases
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Published
10/18/2023
{{c1::Pericarditis}} most often presents with friction rub and chest pain
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10/18/2023
{{c1::Decreased}} pulse pressures are seen in conditions that decrease left ventricular stroke volume
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10/18/2023
What is the effect of cardiac tamponade on pulse pressure?{{c1::Decreased pulse pressure}}
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10/18/2023
Acute {{c1::pericarditis}} is defined as inflammation of the pericardium
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Acute {{c3::pericarditis}} commonly presents with sharp pain that is aggravated by {{c1::inspiration}} and relieved by {{c2::sitting up and leaning fo…
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Acute pericarditis is often complicated by pericardial {{c1::effusion}}
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10/18/2023
ECG changes associated with acute {{c4::pericarditis}} include widespread, diffuse {{c1::ST segment}} {{c2::elevation}} and/or {{c1::PR}} {{c2::depres…
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What is the most common cause of acute pericarditis?{{c1::Idiopathic (presumed viral)}}
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10/18/2023
{{c1::Cardiac tamponade}} is defined as compression of the heart by fluid
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What is the effect of cardiac tamponade on cardiac output? {{c1::Decreased CO}}
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What is the effect of cardiac tamponade on heart rate? {{c1::Increased HR}}
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Cardiac tamponade leads to equilibration of {{c1::diastolic}} pressures in all 4 chambers
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{{c4::Cardiac tamponade}} may present with Beck's triad of {{c1::hypotension}}, {{c2::distended neck veins}}, and {{c3::distant heart sounds}}
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One ECG change associated with cardiac tamponade is a(n) {{c1::low-voltage}} QRS complex
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10/18/2023
One ECG change associated with cardiac tamponade is {{c1::electrical alternans}}, which occurs due to "swinging" movement of the heart in a large effu…
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Cardiac tamponade may be associated with {{c1::pulsus paradoxus}}, which is a(n) {{c4::decrease}} in amplitude of systolic BP > {{c3::10}} mmHG dur…
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10/18/2023
Pneumonia may present as {{c1::tachypnea}} (respiratory rate) with {{c2::pleuritic}} chest pain
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{{c1::Pneumothorax}} is defined as the accumulation of air in the pleural space
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Pneumothorax presents with {{c1::unilateral::uni- or bilateral}} chest pain and expansion, as well as dyspnea
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Pneumothorax presents with {{c1::decreased}} tactile fremitus on the affected side
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Pneumothorax presents with {{c1::hyper}}-resonance on the affected side
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Pneumothorax presents with {{c1::diminished}} breath sounds on the affected side
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10/18/2023
{{c1::Primary spontaneous}} pneumothorax is due to rupture of apical subpleural blebs or cysts
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10/18/2023
What demographic is associated with primary spontaneous pneumothorax? {{c1::Tall, thin, young males}}
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10/18/2023
{{c1::Traumatic}} pneumothorax may be due to iatrogenic causes, such as bronchoscopy, subclavian line placement, thoracentesis, barotrauma
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10/18/2023
In {{c2::tension}} pneumothorax, the trachea +/- mediastinum shifts {{c1::away from}} the side of collapse
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10/18/2023
{{c1::Traumatic}} pneumothorax is caused by blunt or penetrating trauma
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10/18/2023
{{c1::Tension}} pneumothorax arises when air enters the pleural space but cannot exit
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Tension pneumothorax needs immediate needle decompression and {{c1::chest tube}} placement
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10/18/2023
{{c1::Pleural effusion}} is the excess accumulation of fluid between lung pleural layers
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10/18/2023
Pleural effusion causes restricted lung {{c1::inspiration::inspiration or expiration}}
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10/18/2023
Pleural effusion can be treated with {{c1::thoracentesis}} to remove fluid
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{{c2::Transudative}} pleural effusion may be caused by increased {{c1::hydrostatic}} pressure (e.g. HF)
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{{c2::Transudative}} pleural effusion may be caused by decreased {{c1::oncotic}} pressure (e.g. nephrotic syndrome, cirrhosis)
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10/18/2023
{{c2::Transudative}} pleural effusion is characterized by {{c1::low}} protein content
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10/18/2023
{{c2::Exudative}} pleural effusion is caused by states of increased {{c1::vascular permeability}} (e.g. malignancy, pneumonia, trauma, collagen vascul…
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10/18/2023
Exudative pleural effusions must be drained due to risk of {{c1::infection}}
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10/18/2023
A(n) {{c2::lymphatic}} pleural effusion is also known as {{c1::chylothorax}}
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{{c2::Lymphatic}} pleural effusion occurs due to {{c1::thoracic duct}} injury from trauma or malignancy
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Lymphatic pleural effusion is characterized by a(n) {{c1::milky}}-appearing fluid with increased {{c2::triglycerides}}
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Pleural effusion presents with {{c1::decreased::increased or decreased}} breath sounds
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Pleural effusion presents with {{c1::dullness}} to percussion
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Pleural effusion presents with {{c1::decreased}} fremitus
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{{c2::Exudative}} pleural effusion is characterized by {{c1::high}} protein content
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Exudate is characterized by {{c1::increased}} LDH compared to serum
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10/18/2023
Exudate is characterized by {{c1::high}} levels of protein
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10/18/2023
Transudate is characterized by {{c1::decreased}} LDH compared to serum
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Transudate is characterized by {{c1::low}} levels of protein
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Exudative pleural effusions are characterized by a(n) {{c1::> 0.5 (high)}} pleural/serum protein ratio
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Transudative pleural effusions are characterized by {{c1::< 0.6 (low)}} pleural/serum LDH ratio
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10/18/2023
Exudative pleural effusions are characterized by {{c1::> 0.6 (high)}} pleural/serum LDH ratio
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10/18/2023
Which type of parapneumonic effusion, uncomplicated or complicated, is characterized by pH < 7.2? {{c1::Complicated}}
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What is the general treatment for uncomplicated parapneumonic effusion?{{c1::Antibiotics}}
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What is the general treatment for complicated parapneumonic effusion?{{c1::Antibiotics and drainage (e.g. chest tube)}}
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10/18/2023
What type of pleural effusion, transudative or exudative, is commonly seen with pulmonary embolism?{{c1::Exudative (typically a small, bloody effusion…
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10/18/2023
Patients with Cardiac Tamponade have an enlarged "{{c1::water bottle}}" shaped heart on chest x-ray
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Cardiac tamponade may be caused by malignancies / {{c3::radiation}} therapy; infections (most commonly {{c1::viral}}), drugs, and {{c2::connective}} t…
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10/18/2023
Pulsus paradoxus is quantified by measuring the variation of {{c1::systolic}} pressure during expiration and inspiration
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10/18/2023
A tension pneumothorax may lead to {{c1::increased}} intrathoracic pressure, leading to {{c2::decreased}} cardiac function
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10/18/2023
A collapsed lung may present as a(n) {{c1::completely opacified hemithorax}} on chest X-ray
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10/18/2023
What is the recommended treatment for a hemodynamically unstable patient with cardiac tamponade?{{c1::Emergency pericardiocentesis}}
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10/18/2023
What imaging study is used for the definitive diagnosis of cardiac tamponade? {{c1::Echocardiography}}
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10/18/2023
{{c1::Uncomplicated::Uncomplicated/Complicated}} parapneumonic effusions are a type of pleural effusion that causes a sterile exudate in the pleural s…
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10/18/2023
What does this show and what is the next step in diagnosis?{{c1::Pleural effusion; Thoracentesis}}
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10/18/2023
Types of Pleural Effusions:Exudate = {{c1::↑::↑↓↔}} LDH/proteins/lipidsTransudate = {{c1::↓::↑↓↔}} LDH/proteins/lipids
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10/18/2023
Pericardial effusion / tamponade = {{c1::echo::diagnostic tool}}
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10/18/2023
{{c1::Complicated parapneumonic effusion::Complicated or uncomplicated parapneumonic pleural effusion}} has the following: - Leukocyte counts > 50,…
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10/18/2023
Suspected pleural effusion is managed with {{c1::diagnostic thoracocentesis::next step}}
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10/18/2023
Most transudative pleural effusions are caused by:{{c1::CHF::condition::most common}}{{c2::cirrhosis::condition}}{{c3::nephrotic syndrome::condition}}
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10/18/2023
Bloody exudative effusion = {{c2::malignancy}} or {{c1::PE}}
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10/18/2023
Which type of parapneumonic effusion is characterized by the following values:pH > 7.2Glucose > 60 mg/dlWBC < 5…
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10/18/2023
Which type of parapneumonic effusion is characterized by the following values:pH < 7.2Glucose < 60 mg/dlWBC > 5…
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10/18/2023
Which type of parapneumonic effusion is characterized by the following values:pH < 7.2Glucose < 60 mg/dlWBC &…
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10/18/2023
{{c2::Exudative}} pleural effusions must meet one of Light's criteria, which are:Pleural protein/serum protein > {{c1::0.5}}Pleural LDH/serum LDH &…
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10/18/2023
Diagnosis? {{c1::Pleural effusion}}
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Is echocardiography warranted in pericarditis?{{c1::Yes}}
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Viral {{c1::peri}}-carditis may predispose patients to development of cardiac tamponade
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10/18/2023
Malignant pleural effusions are {{c1::exudative::transudative/exudative}}
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What determines the severity of effusion and morbidity in cardiac tamponade?{{c1::The rate of pericardial filling}}
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10/18/2023
What is the treatment for cardiac tamponade?{{c1::Pericardiocentesis + IV fluids}}
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10/18/2023
What intrathoracic pathology may cause a chylous effusion due to obstruction of the thoracic duct?{{c1::Malignancy (e.g.…
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10/18/2023
What is the most common cause of secondary spontaneous pneumothorax?{{c1::COPD (due to parenchymal destruction)}}
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10/18/2023
Whole blood leaking into the pleural cavity causes a(n) {{c2::hemothorax}}, which may contain {{c1::blood clots}} in the fluid collection
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10/18/2023
Hemothorax and chylothorax present with {{c1::dullness::sound}} to percussion on the affected side
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10/18/2023
Parenchymal destruction from malignancy can cause {{c1::secondary spontaneous}} pneumothorax
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10/18/2023
Pulmonary infections (e.g. pneumonia and lung abscess) may cause {{c1::seconday spontaneous}} pneumothorax
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10/18/2023
Infection with {{c1::M. tuberculosis}} may cause pleural or bronchial destruction leading to secondary spontan…
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10/18/2023
{{c1::Tension}} pneumothorax may restrict venous return resulting in hypotension and {{c2::obstructive}} shock
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10/18/2023
Pericarditis is a common cause of cardiac tamponade{{c1::T::T/F}}
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10/18/2023
{{c1::Tension pneumothorax::Respiratory}} may cause kinking of the IVC which results in a decreased {{c2::cardiac output}}
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10/18/2023
Which type of parapneumonic effusion is characterized by low pH, low glucose, and neutrophilia?{{c1::Empyema}}
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10/18/2023
Acute pericarditis presents with a pericardial {{c1::fluid}} accumulation
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10/18/2023
Patients with acute pericarditis are at increased risk for {{c1::cardiac tamponade::cardiac tamponade or mediastinitis}}
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10/18/2023
{{c1::Pleurisy}} is inflammation of the pleura, which can occur due to many causes
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10/18/2023
The {{c1::visceral}} pleura of the lungs is part of the bronchial circulation while the {{c1::parietal}} pleura is part of the systemic circulation.
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10/18/2023
A chest x-ray in the {{c1::lateral decubitus}} position is more sensitive for detecting pleural effusions involving smaller amounts of fluid.
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10/18/2023
What does this CT chest show?{{c1::left pleural effusion}}
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10/18/2023
Re-expansion pulmonary edema is a complication of {{c1::thoracentesis::procedure}} and is treated with {{c2::supplemental O2 and monitored::treatment}…
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10/18/2023
What is the standard treatment for acute pericarditis?{{c1::NSAIDs +/- colchicine}}
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If acute pericarditis does not resolve with NSAIDs +/- colchicine, use {{c1::corticosteroids}}.
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10/18/2023
Why are diuretics not the proper treatment for cardiac tamponade?{{c1::they can worsen tamponade physiology}}
Status
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