Pleural Effusion Flashcards
What is the Lights criteria?
The ratio of pleural to serum protein is greater than 0.5
The ratio of pleural to serum LDH is greater than 0.6
The pleural fluid LDH is greater than ⅔ of the upper limit of normal serum value
What is the pleural: LDH raito in Light’s criteria?
Greater than 0.6
What is the pleural: serum protein ratio in Light’s criteria?
Greater than 0.5
What is the pleural fluid LDH value?
Greater than 2/3 of the normal serum value
What are the symptoms of pleural effusion?
Shortness of breath
Reduced exercise tolerance
Dry cough
Pleuritic chest pain
What are the examination findings for pleural effusion?
Tracheal deviation AWAY from the effusion side
Same side reduced breath sounds, dullness to percussion and chest expansion
What is the cause of transudative pleural effusion?
What is the cause of exudative pleural effusion?
Malignancy
Tuberculosis
Pneumonia causing a parapneumonic effusion
Rheumatoid arthritis
Pancreatitis
Systemic lupus
What is the cause of transudative effusion?
Heart failure
Nephrotic syndrome
Cirrhosis
Hypoalbuminaemia
What is the classification of transudative?
Protein less than 25g/L
What is the classification of exudative?
Protein level more than 35 g/L
What investigation should be done first line?
Pleural tap to aspirate fluid for cytology, biochemistry like pH, protein, LD and glucose and microscopy
When is pleural fluid cholesterol a dn triglycerides?
Chylothorax
When is pleural fluid low in glucose?
Rheumatoid arthritis
Systemic lupus
Empyema
What does pH less 7.2 indicate?
Infection from empyema
Malignancy
What is the first line imaging?
Chest X ray will show blunting of cost Ophir whic angl or white out of lung
What other scan should be considered in suspected liver cirrhosis?
Benign ovarian tumour with ascites that causes TRANSudative pleural effusion
What other scan should be considered in suspected heart failure?
Echocardiogram
What is the intervention for rapidly recurring pleural effusion?
Pleurodesis
Tunnelled indwelling pleural drain, ideal for those receiving palliative drainage
What is the management for pleural effusion?
Analgesia for chest pain
Oxygen for low sat
Resuscitation
Diuretics and antibiotics if necessary
What does pleural fluid LDH > 2/3 indicate?
Related to exudative effusion
What does pleural fluid LDH<2/3 indicate?
Transudative effusion
What is the most common cause of a malignant pleural effusion?
Lung adenocarcionma
