Pleural Diseases and Bronchial Asthma Treatment

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Questions and Answers

What is the primary purpose of thoracocentesis?

Decompression of tension pneumothorax

Removal of fluid from the pleural space (correct)

Treatment of pneumothorax

Management of bronchial asthma

What complication is associated with thoracocentesis?

Hypotension

Pneumothorax (correct)

Coughing fit

Asthma attack

Which of the following is an indication for the use of an intercostal chest tube?

Bronchial asthma

Tension-free pneumothorax

Pleural effusion

Empyema (correct)

What characterizes the triad of symptoms during an asthma attack?

Wheeze, non-productive cough, and dyspnea Signup and view all the answers

Which condition represents the most severe form of asthma?

Status asthmaticus Signup and view all the answers

In the pathophysiology of asthma, which factor is primarily linked to bronchial narrowing due to allergic reactions?

Bronchial hyper-reactivity Signup and view all the answers

What is a common finding in sputum examination for a patient with asthma?

Increased eosinophils Signup and view all the answers

Which test is used to identify the causative antigen in extrinsic asthma?

Skin prick test Signup and view all the answers

Which treatment is considered the best initial therapy during an asthma attack?

Inhaled short-acting B2-agonists (SABA) Signup and view all the answers

What type of pneumonia is primarily caused by Staphylococcus aureus?

Staphylococcal pneumonia Signup and view all the answers

What common symptom is associated with pneumonia?

Expectoration of rusty sputum Signup and view all the answers

Which medication is typically used to treat Mycoplasma pneumonia?

Erythromycin Signup and view all the answers

Which diagnostic test is used for Mycoplasma pneumonia?

Cold agglutination test Signup and view all the answers

What is a characteristic feature of viral pneumonia?

Commonly caused by influenza virus Signup and view all the answers

Which pneumonia is most associated with contaminated water supplies?

Legionella pneumonia Signup and view all the answers

How are inhaled long-acting beta-agonists (LABA) categorized in asthma management?

Controller medications Signup and view all the answers

Study Notes

Pleural Diseases Treatment

Thoracocentesis: Procedure for pleural effusion, extracting fluid via needle inserted above the 10th rib at scapular line.
Requires strict aseptic technique; complications may include hemothorax, pneumothorax, neurogenic shock, or pulmonary edema.
Intercostal Chest Tube: Used for treating pneumothorax (open, bilateral, or tension), empyema, and hemothorax.
Tension Pneumothorax: A medical emergency addressed by immediate needle decompression in the 2nd intercostal space, followed by tube insertion, oxygen, and analgesics.

Bronchial Asthma

Definition: Condition causing bronchial narrowing.
Aetiology: Includes bronchospasm, inflammatory infiltrates (eosinophils), edema, and mucus plugs in bronchi.
Pathophysiology: Types include extrinsic (allergy-related) and intrinsic (hyper-reactivity).
Clinical Picture: Patients typically symptom-free between attacks; common symptoms include wheezing, non-productive cough, dyspnea, and mucous pellet expectoration.
Signs During Attack: Limited respiratory movement, palpable rhonchi, hyper-resonance on percussion, harsh expiratory sounds, and generalized rhonchi.

Complications of Asthma

Respiratory Complications: Status asthmaticus as a severe form, leading to respiratory failure.
General Complications: Treatment side effects (e.g., steroids leading to diabetes and hypertension).
Chronic Cough Complications: Include myositis, rib fractures, pneumothorax, hemoptysis, puffy eyelids, and hernias.

Investigations for Asthma

Sputum Examination: Elevated eosinophils.
Blood Picture: Presence of eosinophilia.
Serum IgE Test: Increased levels indicate extrinsic asthma.
Skin Prick Test: Identifies allergenic causes via intradermal antigens.
Chest X-ray: Reveals hyperinflation during attacks.
Pulmonary Function Tests: Spirometry indicates obstructive hypoventilation.

Treatment of Asthma

Inhaled Short-Acting B2-Agonists (SABA): E.g., Salbutamol for symptomatic relief during attacks.
Inhaled Corticosteroids (ICS): E.g., Beclomethasone, Budesonide for inflammation control.
Inhaled Long-Acting B2-Agonists (LABA): E.g., Salmeterol for prolonged control.
Oral Leukotriene Receptor Antagonists (LTRA): E.g., Montelukast as controller medication.
Oral/Parenteral Steroids: E.g., Prednisolone for severe cases.
IgE Monoclonal Antibodies: E.g., Omalizumab for severe or allergic asthma.

Pneumonia

Clinical Picture: Symptoms include fever, anorexia, headache, malaise, cough, dyspnea, and rusty sputum expectoration.
Signs: Limited respiratory movements on the affected side, increased tactile vocal fremitus, dullness on percussion, bronchial breathing with crepitations on auscultation.

Special Types of Pneumonia

Staphylococcal Pneumonia: Caused by Staphylococcus aureus, treated with nafcillin or vancomycin.
Friedlander's Pneumonia: Associated with Klebsiella, treated with ceftriaxone, mainly affects immunocompromised patients.
Pneumocystis carinii Pneumonia: Caused by Pneumocystis jirovecii in AIDS patients, treated with Septrin or pentamidine.
Mycoplasma Pneumonia: Atypical pneumonia in children and young adults, causes various systemic infections, diagnosed by cold agglutination test, treated with macrolides (e.g., erythromycin).
Legionella Pneumonia: Caused by Legionella pneumophila, associated with contaminated water, diagnosed by urine antigen test, treated with macrolides.

Viral Pneumonia

Atypical pneumonia caused by viruses such as influenza (H1N1, H5N1), CMV, EBV, RSV, measles, and SARS.

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Description

This quiz covers the treatment procedures for pleural diseases such as thoracocentesis and intercostal chest tube placement, alongside the understanding of bronchial asthma. Learn about the emergency protocols for conditions like tension pneumothorax and the pathophysiology of asthma. Test your knowledge on the clinical management of respiratory ailments.