9. Pleural Effusion

Question 1

What is a pleural effusion?

Answer 1

Excess fluid in pleural cavity - imbalance between rate of production an absorption

Question 2

What are the types of pleural effusion?

Answer 2

Simple - fluid is pleural fluid (transudate or exudate)
Haemothorax - fluid is blood (trauma)
Chylothorax - fluid is lymph (leak from lymphatic duct)
Empyema - fluid is pus

Question 3

What are the symptoms of pleural effusion?

Answer 3

SOB
Pleuritic chest pain
Features of underlying clinical disease - congestive cardiac failure, lung malignancy

Question 4

What are the signs of pleural effusion?

Answer 4

Trachea deviation - away from affected side in serious cases
Chest movement - reduced on affected side
Percussion note - dull on affected side
Breath sounds - reduced/absent on affected side
Vocal resonance - reduced on affected side

Question 5

What are I further investigations for pleural effusions?

Answer 5

Pleural aspiration - send fluid off for protein levels, glucose levels, LDH, MC and S, pH

Question 6

What is transudate?

Answer 6

Large protein molecules do not pass through the pores in the capillary
Congestive cardiac failure
Hypoproteinaemia

Question 7

What is exudate?

Answer 7

Protein molecules pass through the leaky capillary
Infection - TB, pneumonia
Lung malignancy
Pulmonary infarction

Question 8

What is the treatment for pleural effusion?

Answer 8

In very symptomatic patients - chest aspiration

Recurrent effusions - indwelling pleural catheter, pleurodesis