Pleural Disorders

Question 1

Pleural Effusion Chest X-Ray: PA & Lateral-Decub

Answer 1

blunting of either costophrenic angle is indicative of the accumulation of between 250 - 500 ml of fluid

Question 2

Pleural Fluid Analysis Light’s Criteria

Answer 2

If at least one of the following three criteria is present, the fluid is defined as an exudate:
Pleural fluid protein/serum protein ratio > 0.5.
Pleural fluid LDH/serum LDH ratio > 0.6.
Pleural fluid LDH greater than two thirds the upper limits of the laboratory’s normal serum LDH.

Question 3

Pleural Effusions Exudative Causes:

Answer 3

Neoplasm
Infection (mycoplasma, TB, pneumonia, etc)
Autoimmune disease
Pulmonary infarction
Intra-abdominal pathology

Question 4

Transudative Pleural Effusions

Answer 4

straw-colored, clear, odorless fluid
Anything that causes increased hydrostatic pressure or decreased capillary colloid osmotic pressure
Ex:
Congestive Heart Failure (most common cause)
Severe hypoalbuminemia (liver disease)
Cirrhosis (associated with ascites)

Question 5

paraneumonic Effusions

Answer 5

Pleural effusions that occur in the pleural space adjacent to a bacterial pneumonia.
if bacteria invade the pleural space, a complicated parapneumonic effusion or empyema may result.