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Pleural Disease (Mesothelioma (Symptoms: Slow onset (Cough, Dyspnea, Chest…
Pleural Disease
Mesothelioma
Tumor of mesothelial cells in pleura caused by asbestos
Exposure: ship yard
Takes decades post encounter
Symptoms: Slow onset
Cough
Dyspnea
Chest pain
Prognosis: poor--> months
Imaging: CXR
pleural thickening
Pleural effusion
Pleural effusion: accumulation of fluid in pleural space
Exudative
Leaky BV--> proteins leak too!
Malignancy or pneumonia
Treatment: drainage
Lympocytic
Due to blockage of thoracic duct
Malignancy or trauma
Transductive
Excess liquid, low protein
Due to HF (high liquid), or nephrotic syndrome or cirrohsis
Tx: treat underlying cause
Pneumothorax: Air in pleural space
Types
Spontaneous
Secondary
Lung damage: smoking, COPD
Primary
Bleb rupture: tall male
Sx
sudden
onset of dypnea
Pleuritic chest pain
Trachea towards the affected side
Treatment
100% oxygen, chest tube
Tension
Due to trauma. Air enters lung cannot leave. Leads to pressure build up in lung + compresses veins => decrease preload
sx: JVD possible due to insufficient venous return
tx: emergency, thoracentesis, chest tube