Pleural Diseases

Question 1

What are the three most common causes of pleural effusion in the US?

Answer 1

Heart failure, pneumonia, and cancer.

Question 2

3 most common symptoms of pleural effusions?

Answer 2

Fever, dyspnea, and chest pain

Question 3

Bilateral transudative effusions are commonly associated with what two conditions?

Answer 3

Heart or liver failure

Question 4

Bilateral exudative effusions suggest what two things?

Answer 4

Malignancy or pleuritis

Question 5

3 things causing exudative pleural effusions?

Answer 5

Malignancy, inflammation, and infection

Question 6

What is the overarching pathogenesis of transudative effusions and what are two specific examples?

Answer 6

These are due more to an unbalance of hydrostatic forces like heart failure and cirrhosis.

Question 7

3 criteria for exudative effusions?

Answer 7

Pleural protein/serum protein ratio greater than .5
Pleural LDH/serum LDH ratio grater than .6
Pleural fluid LDH is greater than 2/3 upper limit of serum LDH

Question 8

What is the most likely diagnosis of pleural leukocyte counter over 10k?

Answer 8

Effusion because of pneumonia

Question 9

What about if the count is over 50k?

Answer 9

Complicated pneumonia or empyema

Question 10

What kind of exudate presents with malignancy or TB?

Answer 10

Lymphocyte dominant

Question 11

What are 4 causes of effusion where the pleural glucose is low?

Answer 11

Malignancy, pneumonia, RA, TB

Question 12

4 causes of eosinophil increases in the pleura?

Answer 12

Air, idiopathic, pneumonia, and malignancy

Question 13

What are the two treatments he talked about for chronic pleural effusions?

Answer 13

PleurX catheter and pleurodesis

Question 14

What is pleurodesis?

Answer 14

Obliteration of the pleural space with a chemical agent like talc