High-Yield Concepts in Pleural Effusion and Pneumothorax

Question 1

First step in the diagnostic approach to pleural effusion

Answer 1

Determine whether effusion is a transudate or exudate

Question 2

Leading causes of transudative pleural effusion

Answer 2

LV failure and cirrhosis

Question 3

Leading causes of exudative pleural effusion

Answer 3

Bacterial pneumonia, malignancy, viral infection, pulmonary embolism

Question 4

Most common cause of chylous pleural effusion

Answer 4

Malignancy

Question 5

Three tumors that cause ~75% of all malignant pleural effusions

Answer 5

Lung carcinoma
Breast carcinoma
Lymphoma

Question 6

Benign ovarian tumors producing ascites and pleural effusion

Answer 6

Meigs’ syndrome

Question 7

The only symptom that can be attributed to the malignant effusion itself

Answer 7

Dyspnea

Question 8

Condition most commonly overlooked in the differential diagnosis of a patient with an undiagnosed effusion

Answer 8

Pulmonary embolism

Question 9

Most common cause of chylothorax

Answer 9

Trauma (most frequently thoracic surgery)

Question 10

Treatment of choice for most cases of chylothorax

Answer 10

Insertion of a chest tube plus administration of ocreotide

Question 11

Population at risk for spontaneous pneumothorax

Answer 11

Tall thin men 20-40 y/o, smoker

Question 12

Tracheal deviation in spontaneous pneumothorax

Answer 12

Ipsilateral tracheal deviation

Question 13

Tracheal deviation in tension pneumothorax

Answer 13

Contralateral tracheal deviation