Pleural effusion Flashcards
1
Q
Transudate
A
Low protein content
Due to increased hydrostatic pressure or decreased oncotic pressure
2
Q
Exudate
A
Protein rich > 30g/L
Due to inflammation causing increased vascular permeability
3
Q
Causes of exudate
A
Infection: pneumonia, TB
Neoplasm: bronchial, lymphoma, mesothelioma
Inflammation: RA, SLE
Infarction
4
Q
Causes of transudates
A
Transudates:
- Congestive HF
- Nephrotic disease - ↓ albumin
- Liver failure
- Ascites
5
Q
Presentation of pleural effusion
A
Symptoms
- Dyspnoea
- Pleuritic chest pain
Signs
- Tracheal deviation away from effusion
- ↓ expansion
- Stony dull percussion
- Bronchial breathing
- ↓VR
Associated disease Ca: cachexia, clubbing Chronic liver disease Cardiac failure RA, SLE Hypothyroidism
6
Q
Ix
A
Respiratory exam Basic obs Blood: FBC, U+E, LFT, TFT, CRP CXR USS guided volumetric aspiration Contrast CT Aspiration - MCS, cytology
7
Q
Signs of pleural effusion on CXR
A
Blunt costophrenic angles Dense shadow with meniscus
Mediastinal shift away
8
Q
Empyema
A
↑ protein
↓ glucose
↓ pH <7.2
↑ LDH
9
Q
Mx
A
Treat underlying cause
Drainage if symptomatic
Repeated aspiration or ICD
