MSRA: Pleural Disease

Question 1

What is Light’s criteria?

Answer 1

If pleural fluid protein level between 25 and 35g/L (I.e. Borderline), exudate if one of the following:
Pleural fluid/serum protein >0.5
Pleural fluid/serum LDH >0.6
Pleural fluid LDH >2/3 of the upper limit of normal

Question 2

What advice should be given to patients following a pneumothorax?

Answer 2

Avoid air travel 7/7
Avoid diving - permanently
Smoking cessation

Question 3

What are the BTS guidelines in the management of a secondary spontaneous pneumothorax?

Answer 3

Air rim >2cm or breathless - chest drain
If 1-2cm or not breathless - consider aspiration - if fails - chest drain
If less than 1cm - admit for 24hours for observation and oxygen

Question 4

What are the BTS guidelines in the management of a primary spontaneous pneumothorax?

Answer 4

If breathless/>2cm air rim - aspirate
If aspiration fails, or still breathless or air rim persists - consider chest drain
If not breathless or air rim less than 2cm - consider discharge with OP CXR

Question 5

What are the indications for chest drain insertion with pleural effusion?

Answer 5

pH less than 7.2
Presence of organisms
Purulent/cloudy pleural fluid

Question 6

True or False.
Ehlers-Danlos syndrome is associated with spontaenous pneumothorax?

Answer 6

False
Marfans syndorme is associated with spontaneous pneumothorax