Pleural Disease

Question 1

Causes of transudative pleural effusions

Answer 1

1. Left ventricular heart failure
2. Liver Failure
3. Peritoneal dialysis
4. hypoproteinemia [Nephrotic syndrome]
5. Hypothyroidism
6. mitral stenosis
7. Ovarian tumors [Meigs Syndrome]

Question 2

Causes of exudative pleural effusion

Answer 2

1. TB
2. Parapneumonic effusion/ Empyema
3. Pulmonary/ Non- pulmonary malignancy
4. Sarcoid (rare)
5. Mesothelioma (rare)
6. PE
7. Hemothorax
8. PANCREATITS
9. Benign asbestos

Question 3

Lights Criteria

Answer 3

For fluid to be exudative,

1. Pleural fluid protein: Serum fluid protein >.05
2. Pleural fluid LDH: Serum LDH> .06
3. Pleural fluid LDH >2/3 of upper limit of normal for serum