Are you ready to learn about Pleural Diseases? If so then you’re in the right place, because that is what this study guide is all about.

The information found here correlates well with Egan’s Chapter 27, so you can use these practice questions to help prepare for your exams.

So without further ado, let’s going ahead and dive right in!

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Pleural Diseases Practice Questions:

1. What are the two most common pleural diseases that you should know about as a Respiratory Therapist?
Pleural effusion and pneumothorax.

2. When do pleural effusions form?
When excess pleural fluid is produced by the lung or chest wall in sufficient quantities to overcome the resorptive capacity of the pleural lymphatic vessels.

3. Pleural fluid analysis is the key to what?
It is the key to understanding the specific cause of any pleural effusion.

4. Transudates have a pleural fluid total protein level of what?
Less than 0.5 and an LDH level of less than 0.6 of the respective serum values.

5. What are the common causes of a transudative effusion?
The common causes include CHF, nephrosis, and cirrhosis.

6. Pleural fluid drainage returns approximately one-third of the lung volume as measured by what?
FVC. The other two-thirds of fluid drainage allows the diaphragm to rise and the chest wall to normalize.

7. Is a pneumothorax size underestimated or overestimated with a one-dimensional view of the chest?
It is underestimated. Measurement accuracy requires a three-dimensional perspective.

8. Are the risk factors for a pneumothorax and pneumomediastinum the same?
Yes; air ruptures a pleural membrane in pneumothorax, and air passes through the lung hilum in pneumomediastinum.

9. Oxygen therapy speeds resolution of all pneumothoraces by?
By improving N absorption.

10. Chest tube flow depends on what?
It depends on tube size, stopcock size, and collection system resistance.

11. Breath-by-breath measurement of an air leak can be approximated by what?
By the difference between inspired and expired volumes (in the absence of endotracheal cuff leaks).

12. The mode of ventilation that produces the least fistula airflow is the most likely to produce what?
Healing

13. What are the methods to decrease BPF airflow?
Lowering tidal volume, lowering respiratory rate, lowering PEEP, and avoiding auto-PEEP. In more severe cases, positioning the affected lung down, double-lumen tube ventilation, adding PEEP valves to the chest tube, inspiratory chest tube occlusion, or thoracic surgery should be considered.

14. What is a Bronchopleural Fistula?
Any air communication from the lungs to pleural space

15. What is a Empyema?
Pus within the pleural space. A pleural fluid Gram stain that shows bacteria.

16. What is an Exudative Pleural Effusion?
Any pleural effusion high in protein or lactate dehydrogenase, which implies inflammation or vascular injury on the pleural surface

17. What is a Hemothorax?
Presence of blood within the pleural space.

18. What is the Parietal Pleura?
Membrane covering the surface of the chest wall, mediastinum, and diaphragm that is continuous with the visceral pleura around the lung hilum

19. What is a Pleural Effusion?
Abnormal collection of fluid within the pleural space.

20. What is a Pleurodesis?
Procedure of fusing the parietal pleura and visceral pleura to prevent formation of pleural fluid or recurrence of pneumothorax.

21. What is a Primary Spontaneous Pneumothorax?
A pneumothorax that occurs without underlying lung disease

22. What is Re-expansion Pulmonary Edema?
Pulmonary edema that forms after rapid re-expansion of a lung that has been compressed with pleural fluid or pneumothorax.

23. What is a Secondary Spontaneous Pneumothorax?
A pneumothorax that occurs because of underlying lung disease.

24. What is a Stomata?
Small holes within the parietal pleura that are the main route for pleural fluid to exit.

25. What is a Thoracentesis?
Surgical perforation of the chest wall and pleural space with a needle for diagnostic or therapeutic purposes or for removal of a specimen for biopsy.

26. What is a Transudative Pleural Effusion?
Pleural effusion low in protein or lactate dehydrogenase, usually caused by congestive heart failure, nephrosis, or cirrhosis.

27. What is Ascites?
The accumulation of fluid in the abdomen.

28. What is Atelectasis?
When segments of the lung collapse, intrapleural pressure becomes more negative and can produce small effusions.

29. What is a Bronchopleural Fistula?
Any air communication from the lungs to pleural space.

30. How is Chest Radiography used for pleural diseases?
It is most common in detecting a pleural effusion obtained best in the upright position to show a pleural fluid meniscus at the costophrenic angles.

31. How is CHF relevant to pleural diseases?
It is the most common cause of a clinical pleural effusion. It stems from the elevation of pressure in the left atrium and pulmonary veins.

32. How is Computed Tomography relevant to pleural diseases?
CT scanning of the chest is the most sensitive study for identification of pleural effusion.

33. What is an Empyema?
Pus or bacteria within the pleural space. Also seen on Gram stain as pus or bacteria. Necessitates drainage.

34. What is a Exudative Pleural Effusion?
Any pleural effusion high in protein or lactate dehydrogenase, which implies inflammation or vascular injury on the pleural surface.

35. What is Hypoalbuminemia?
It is caused by debilitating diseases (AIDS, Chronic Liver Disease) but rarely forms until the albumin level is < 1.8g/dl.

36. What is Hypoxemia?
It is due to alveolar-arterial gradient increase, oxygenation can worsen after a thoracentesis, V/Q matching is not instantaneous. usually, 90 min to recover to baseline PO2.

37. What is lateral decubitus chest radiography used for?
It can help define the presence or absence of pleural effusion.

38. What is a Lymphatic Obstruction?
An obstruction that causes pleural fluid from the pleural space. The most common condition causing this abnormality is cancer that metastasizes to the mediastinum.

39. What is Nephrotic Syndrome?
When greater than 3 g/24 hour of protein S leaks from the kidney into urine, causing a depletion of protein, the patient can become edematous. The patients are at risk for Deep Vein Thrombosis and Pulmonary Emboli.

40. What is the Parietal Pleura?
Membrane covering the surface of the chest wall, mediastinum, and diaphragm that is continuous with the visceral pleura around the lung hilum.

41. What is Pleurisy?
Small pleural effusions, and pain. This can come from a viral lung infection which can cause pleural inflammation.

42. What is Pleurodesis?
Procedure of fusing the parietal pleura and visceral pleura to prevent formation of pleural fluid or reccurrence of pneumothorax.

43. What is a Primary Spontaneous Pneumothorax?
A pneumothorax that occurs without underlying lung disease.

44. What is Re-expansion Pulmonary Edema?
Pulmonary edema that forms after rapid re-expansion of a lung that has been compressed with pleural fluid or pneumothorax.

45. What is a Secondary Spontaneous Pneumothorax?
A pneumothorax that occurs because of underlying lung disease.

46. What is a Stomata?
Small holes within the parietal pleura that are the main route for pleural fluid to exit.

47. What is a Thoracentesis?
Perforation of the chest wall superior to the rib and pleural space with a needle for diagnostic of therapeutic purposes or for removal of a specimen for biopsy. These account for about 70% of all pleural effusion.

48. What are the risk factors of a Thoracentesis?
(1) Intercostal artery laceration, (2) Infection, (3) Pneumothorax (needle puncture is one of the most common causes).

Final Thoughts

Thank you so much for reading all the way to the end of our study guide on Pleural Diseases. By doing so, that let’s me know that you’re willing to do whatever it takes to become a successful Respiratory Therapist, and I commend you for that. Thanks again for reading and as always, breathe easy my friend.

? And don’t forget, if you need help with your Egan’s Workbook, we looked up the answers for you so that you don’t have to. Check out our Workbook Helper to learn more.

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