Pleural effusion Flashcards
Definition of exudative and transudative pleural effusion?
collection of fluid in the pleural cavity.
transudative= lower protein count <3g/L
exudative= high protein count >3g/L
What are the components of Light’s criteria?
Effusion: serum protein >0.5
Effusion: serum LDH >0.6
Effusion LDH is 0.6 x upper limit of normal
Light’s critera is applied to which type of pleural effusion?
exudative
How do exudates causes pleural effusion?
inflammation results in protein leaking out of tissues and into pleural space
Three causes of exudative pleural effusion?
- Infection- pneumonia, TB
- Neoplasm: bronchial, mesothelioma
- Inflammation: RA, SLE
- Infarction
Three causes of transudative pleural effusion?
reduced oncotic pressure or increased capillary hydrostatic pressure
- Congestive heart failure
- Renal failure
- Hypothryoidism
- Hypoalbuminaemia (liver failure)
- Meig’s syndrome
Which syndrome associated with ovarian malignancy can result in pleural effusion?
Meig’s syndrome
If tracheal deviation is present, does it go towards or away from the pleural effusion?
away from the effusion
Three signs of pleural effusion on examination?
Tracheal deviation away from effusion
↓ expansion
Stony dull percussion
↓ air entry
Bronchial breathing just above effusion
↓VR
Two investigations for pleural effusion?
CXR
Bloods
Diagnostic tap
Name two findings on CXR of pleural effusion?
costophrenic angle blunting dense shadow with meniscus sign mediastinal shift away from effusion fluid in lung fissues cause of effusion e.g. coin lesion, cardiomegaly
Exudative sample from diagnostic tap will show which biochemical features
Raised protein
Low glucose
Low pH
High LDH
Which results can be acquired from diagnostic tap of pleural fluid?
chemistry- protein, LDH
Bacteriology: TB
Immunology
Two management options for pleural effusion?
treat underlying cause
chest drain
pleural aspiration
Two findings that you might encounter during systemic examination for pleural effusion?
clubbing, ascites, lymphadenopathy
