Disorders of the pleura Flashcards
Pleural effusion post CABG
Early <30 days: bloody, eosinophillic
Late >30 days: clear, lymphocytic
Chylothorax
diagnosis and causes
Triglyceride >1.24mmol/L exclude if <0.56; Chylomicrons
Trauma
Thoracotomy
Malignancy including lymphoma
LAM
TB
Cirrhosis
Pseudochylothorax
diagnosis and cause
Cholesterol >5.17
Cholesterol crystals - polarised light microscopy
TB
RA
Causes of transudative pleural effusion
LVF
Atelectasis
Chronic liver disease
Hypoalbuminaemia
peritoneal dialysis
PE
nephrotic syndrome
constrictive pericarditis
hypothyroidism
meig’s syndrome
mitral stenosis
urinothorax
Causes of exudative pleural effusion
simple parapneumonic effusion
malignancy
TB
empyema
PE
RA/SLE/other AI disease
Sarcoidosis
oesophageal rupture
pancreatitis
post-cardiac injury (dresslers)/;post-CABG
Radiotherapy
Chylothorax
drug induced
fungal
yellow nail syndrome
Lights criteria
Pleural:serum protein >0.5
Pleural: serum LDH >0.6
Pleural LDT >2/3 upper limits serum LDH
Distinction of pleural effusion in RA
glucose <1.6mmol/L
Drugs that cause pleural effusion
Exudative
Amiodarone
beta blockers
methotrexate
bromocriptine
nitrofurantoin
phenytoin
Causes of lymphocytes in pleural effusion
TB
cardiac failure
malignancy
sarcoidosis
lymphoma
rheumatoid pleurisy
post-CABG
chylothorax
Causes of neutrophilic effusions
acute - parapneumonic, PE
causes of mononuclear cells in effusions
chronic effusion, malignancy, TB
causes of eosinophils in effusions
often unhelpful
air/blood in pleural space (haemothorax, pulmonary infarct, pneumothorax, previous tap)
malignancy
infection (parapneumonic, TB, fungal, parasitic)
drug- and asbestos induced effusions
EGPA
idiopathic
Causes of haemothorax
malignancy
PE
trauma
asbestosis benign effusion
post-cardiac injury
