Pleural Effusion Flashcards
Pleural effusion is where there is excess fluid accumulation between the ____ and ____ pleura layers
visceral and parietal
Fluid in pleural effusion is either t____ or e_____
transudative or exudative
What is transudative fluid and what causes it?
Low protein, under 25 g/l
High hydrostatic pressure or low oncotic pressure
What conditions cause high hydrostatic pressure or low oncotic pressure resulting in transudative fluid?
Congestive heart failure
Liver cirrhosis
Nephrotic syndrome (hypoalbuminemia so low oncotic pressure)
Is transudative fluid transparent of cloudy?
transparent
What is exudative fluid and what causes it?
High protein, over 35 g/l
Due to inflammation causing increased vascular permeability
What conditions can cause exudative due to vascular permeability from inflammation ?
Cancer
TB
Pneumonia
Is exudative transparent or cloudy?
Cloudy
When is Light’s criteria used in pleural effusion?
When the protein content is between 25-35 g/l
What are symptoms of pleural effusion?
Dyspnoea
Pleuritic chest pain
Cough
Dull percussion (due to increased fluid) on ipsilateral side
If the patient had all the symptoms of pleural effusion with a hyperresonant chest, what condition are you suspecting?
Pneumothorax
What is the gold standard and 1st line method for diagnosing pleural effusion?
Chest XR showing low costophrenic angle (blunting)
Excess fluid appears white
Possible tracheal deviation
Other than a chest XR, what else is used to diagnose pleural effusion?
Thoracentesis (aspiration of pleural fluid):
Find pH, lactase, WCC, microscopy, whether transudate or exudate
What is treatment for pleural effusion?
Chest drain
What is treatment for recurrent pleural effusion?
Pleurodesis
Surgical fusing of pleural layers to prevent fluid build up
