Pleural Diseases Treatment Quiz

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Questions and Answers

What is the best initial treatment for asthma during an attack?

Oral leukotriene receptor antagonists (LTRA)

Inhaled corticosteroids (ICS)

Inhaled long-acting B-agonists (LABA)

Inhaled short-acting B2-agonists (SABA) (correct)

Which type of pneumonia is specifically associated with Staphylococcus aureus?

Mycoplasma pneumonia

Legionella pneumonia

Staphylococcal pneumonia (correct)

Klebsiella pneumonia

What is a common symptom of pneumonia?

Chest pain during palpation

Fever and malaise (correct)

Increased appetite

Expectoration of clear sputum

Which treatment is recommended for Pneumocystis carinii pneumonia?

Septrin or pentamidine Signup and view all the answers

Which pneumonia primarily affects immunosuppressed patients, particularly diabetics?

Fridlander's pneumonia Signup and view all the answers

What lab test is typically used to diagnose Mycoplasma pneumonia?

Cold agglutination test Signup and view all the answers

What is the primary indication for performing a thoracocentesis?

Removal of fluid in pleural effusion Signup and view all the answers

Which of the following is a common sign detected during the auscultation of pneumonia?

Bronchial breathing with crepitations Signup and view all the answers

Which medication is classified as a controller medication for asthma?

Inhaled long-acting B-agonists (LABA) Signup and view all the answers

Which of the following is a complication associated with thoracocentesis?

Pneumothorax Signup and view all the answers

Legionella pneumonia is primarily diagnosed using which of the following tests?

Urine antigen test Signup and view all the answers

Which physiological mechanism leads to bronchial narrowing in asthma?

Spasm of bronchial smooth muscles Signup and view all the answers

Which symptom is characteristic of cough in pneumonia?

Expectoration of rusty sputum Signup and view all the answers

In which phase of an asthma attack might a patient expect to expel small viscid sputum?

At the end of the attack Signup and view all the answers

Which type of asthma is characterized by bronchial hyper-reactivity without a clear allergen?

Intrinsic asthma Signup and view all the answers

What can result from chronic coughing in asthma patients?

Myositis and rib fractures Signup and view all the answers

Which diagnostic finding is specific to extrinsic asthma?

Increased eosinophilia in blood picture Signup and view all the answers

What immediate action is necessary to treat a tension pneumothorax?

Insertion of a wide-bore needle for decompression Signup and view all the answers

Which sign is typically observed during an asthma attack?

Bilateral hyper-resonance on percussion Signup and view all the answers

What is a significant complication of asthma treatment often associated with steroid use?

Diabetes mellitus Signup and view all the answers

Study Notes

Pleural Diseases Treatment

Thoracocentesis
- Indicated for pleural effusion; involves needle insertion superior to the rib at scapular line below the 10th rib.
- Must be performed under strict aseptic conditions to prevent complications such as hemothorax or pneumothorax.
Intercostal Chest Tube
- Used for conditions like pneumothorax (open, bilateral, or tension), empyema, and hemothorax.
Tension Pneumothorax Management
- A medical emergency requiring immediate wide-bore needle insertion in the 2nd intercostal space for decompression, followed by intercostal chest tube insertion, and administration of oxygen and analgesics.

Bronchial Asthma

Definition and Aetiology
- Characterized by bronchial narrowing due to bronchospasm, eosinophil infiltration, and mucus accumulation.
Pathophysiology
- Can be triggered by allergens (extrinsic or atopic asthma) or bronchial hyper-reactivity (intrinsic asthma).
Clinical Presentation
- Symptom-free between episodes; common symptoms include nocturnal attacks, wheezing, non-productive cough, and dyspnea.
- End of attack may involve expectoration of thick, viscid sputum.
Signs During an Attack
- Inspection reveals restricted respiratory movement; palpable rhonchi noted on palpation.
- Percussion shows bilateral hyper-resonance; auscultation presents prolonged expiration and generalized rhonchi.
Complications
- Respiratory: status asthmaticus and respiratory failure.
- General complications of treatment (e.g., steroid side effects).
- Chronic cough can lead to thoracic (myositis, rib fractures) and extra-thoracic issues (hernia).
Investigations
- Sputum examination shows increased eosinophils; blood tests reveal eosinophilia.
- Elevated serum IgE in extrinsic asthma; skin prick tests identify allergens.
- Chest X-ray may show hyperinflation during an attack; pulmonary function tests reveal obstructive hypoventilation.
Treatment
- Short-acting B2-agonists (SABA) (e.g., Salbutamol) for immediate relief.
- Inhaled corticosteroids (ICS) (e.g., Beclomethasone) for control.
- Long-acting B2-agonists (LABA) (e.g., Salmeterol) for ongoing management.
- Oral leukotriene receptor antagonists (LTRA) (e.g., Montelukast) and oral steroids (e.g., prednisolone) for severe cases.
- IgE monoclonal antibodies (e.g., Omalizumab) as an additional treatment option.

Pneumonia

Clinical Picture
- Constitutional symptoms: fever, anorexia, headache, malaise, alongside cough and dyspnea with rusty sputum.
Signs of Pneumonia
- Inspection shows limited respiratory movement on the affected side; palpation reveals increased tactile vocal fremitus.
- Percussion indicates dullness; auscultation findings include bronchial breathing and crepitations.

Special Types of Pneumonia

Staphylococcal Pneumonia
- Caused by Staphylococcus aureus; treated with nafcillin or vancomycin.
Friedlander's Pneumonia
- Caused by Klebsiella, especially in immunocompromised patients (e.g., diabetics); treated with ceftriaxone.
Pneumocystis Carinii Pneumonia
- Fungal pneumonia in AIDS patients; treated with Septrin or pentamidine.
Mycoplasma Pneumonia (Atypical)
- Common in children and young adults; associated with systemic infections; diagnosed by cold agglutination test and treated with macrolides (e.g., erythromycin).
Legionella Pneumonia
- Caused by Legionella pneumophila from contaminated water; leads to hyponatremia; diagnosed via urine antigen test and treated with macrolides.
Viral Pneumonia
- Atypical pneumonia caused by various viruses including influenza, CMV, EBV, RSV, measles, and coronaviruses.

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Description

Test your knowledge on the treatment of pleural diseases, focusing on procedures like thoracocentesis and intercostal chest tube placement. This quiz covers complications and indications for various treatments related to pleural effusion, pneumothorax, and more. Perfect for medical students and healthcare professionals.