SPECIAL SELECTED TOPICS- RESPIRATORY SYSTEM DISORDERS-SSTRSDO-QAA 023
1.
Describe the content of a typical empyema.
Empyema is the accumulation of pus within the pleural cavity,
usually resulting from bacterial pneumonia, lung abscess, thoracic surgery, or
chest trauma. The pleural cavity contains thick yellow-green purulent exudate
composed of numerous neutrophils, necrotic cellular debris, fibrin, bacteria,
and protein-rich fluid.
The pleural surfaces become inflamed, roughened, and coated
with fibrin. As healing occurs, fibroblasts organize the fibrin, leading to
pleural adhesions and fibrosis. Untreated empyema may become loculated and
difficult to drain. Severe cases may progress to sepsis or bronchopleural
fistula.
Patients present with fever, pleuritic chest pain, cough, and
dyspnea. Prompt drainage combined with appropriate antibiotics is essential for
successful treatment.
2.
Describe the main types of pneumothorax.
Pneumothorax is the presence of air within the pleural
cavity, resulting in partial or complete collapse of the lung. Spontaneous
pneumothorax occurs without trauma and is classified as primary or secondary.
Primary spontaneous pneumothorax commonly results from
rupture of subpleural blebs in otherwise healthy young adults. Secondary
spontaneous pneumothorax develops in patients with underlying lung diseases
such as COPD, tuberculosis, cystic fibrosis, or interstitial lung disease.
Traumatic pneumothorax follows penetrating or blunt chest
injury or medical procedures. Tension pneumothorax is a life-threatening
emergency in which air enters the pleural cavity but cannot escape, causing
progressive mediastinal shift and cardiovascular compromise.
Patients present with sudden chest pain, dyspnea, and
reduced breath sounds. Immediate decompression is required in tension
pneumothorax.
PROFESSOR OF MEDICINE
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