Pleural Effusion * Flashcards
What is pleural effusion
Fluid in the pleural cavity between parietal and visceral pleura
What are the two types of pleural effusion
Exudative (High protein)
Transudative (Low protein)
Transudative (Low protein)
What are the Exudative causes of Pleural effusion (Inflammation)
Inflammation INCREASED VASCULAR PERMEABILITY Pneumonia and TB Bronchial carcinoma Rheumatoid, Lupus and Pancreatitis PE and trauma
What are the Transudative causes or Pleural effusion (Fluid shift)
INCREASED HYDROSTATIC PRESSURE
LOW ONCOTIC PRESSURE
Heart Failure
Fluid overload
Hypoalbuminemia (Cirrhosis and nephrotic)
CKD and Coeliac
What are the Presentations of pleural effusion
Decreased chest expansion and breath sounds
Stony dull percussion (ipsilateral side)
SOB/ dyspnoea/ Pleuritic chest pain w/ Cough
What is the Gold and first line investigation for pleural effusion
CXR
- Blunting of costophrenic angle
- Fluid in fissure = white image
- Tracheal deviation
What are the investigations for Pleural effusion
CXR - Gold Thoracentesis (Pleural fluid analysis) -Protein count -Cell count -pH - Glucose Microbiology
How is pleural effusion managed
Pleural aspiration
Pleurodesis for recurrent
ABx for infection
Diuretics for Fluid overload/RHF
How does the fluid appear if the cause of pleural effusion is transudative pressure
Transparent
Exudative inflammatory fluid appears cloudy, what criteria is used to distinguish fluid grey area (25-35g/L)
Lights criteria
-protein 25-35g/L
When is Pleurodosis used
Recurrent Pleural effusion
What colour is the fluid of exudative effusion
Cloudy (High protein)
Pleural effusion presnts w/ Dull percussion, What differential presents with hyper-resonance
Pneumothorax
What is the main difference between pleaural effusion and pneumothorax
Pleural effusion
-fluid between parietal and visceral pleura
Pneumothorax
-Air in pleural space
What side does auscultation show dull percussion
Ipsilateral to fluid accumulation
