Pleural disease Flashcards
what is pleural effusion
intra pleural space space filled with fluid compressing lung. Affects breathing can cause respiratory failure
How do you access pleural fluid
do a thoracocentesis and tes protein, LDH, cytology, glucuse and afb and mcs
how do decide if liquid is transudate or exudate
exudate is over 35g/l
transudate is less than 25g/l
What is light’s criteria
use to decide if fluid is between 25-35g/l for protein conc is transudate or exudate.
it is an exudate if pleural ldh is >0.6
exudate if pleural protein is greater than 0.5
pleural ldh is greater than two thirds lab normal ldh
only one criteria needs to be met
why is it useful to know if pleural fluid is transudate or exudate
transduates often due to systematic problem and exudate due to local problem normally
what does low glucose suggest in pleural fluid
infection mainly can also indicate RA Malignancy Tuberculous Oesophageal rupture SLE
what does low ph suggest in pleural fluid
infection, respiring microbes
describe chracteristics of SIMPLE
PARAPNEUMONIC
EFFUSION
no neutrophils, no organisms presnet in pleural fluid,
what is empyema
pleural effusion which is filled with pus, nutrophils conc high, culture should show pathogen, low ph and glucose, withy high ldh typical of infection
how do you treat empyema
drain pleural fluid(pus like) with a one way draining tube
what are two symptoms in lung disease that could suggest cancer
weight loss and coughing up blood
what would you see in pleural fluid cytology if the effusion is being caused by lung cancer
Metastatic
adenocarcinoma,
lung origin
if fluid in pleural space is bilateral what is it likely to be
heart failiure, congestive or left sided
what is are the ways in which to distinguish between pneumothorax and pleural effusion
percussion note in pnemothorax will go up resonant because it is air, pleural effusion will be dull and xray. you can see smaller lung, or wispy lines where lung should be are gone
