pleural effusion

Question 1

what is a transudate effusion and what are the causes of it?

Answer 1

• an effusion fluid that is low in proteins and lactic dehydrogenase
• it is caused by things that cause an increased venous return eg.
• • heart failure, constrictive pericarditis, fluid overload

or can be due to things that decrease proteins such as nephrotic syndrome

in addition other causes are hypothyroidism and Meigs syndrome which is an ovarian tumour

Question 2

what is an exudate effusion?

Answer 2

an exudate effusion has high protein content and high lactic dehydrogenase
it is often due to leakiness of the capillaries
- infection: pneumonia/ tb
- malignancy - bronchial carcinoma
- RA
- CTDs
- pleural infarcts- will have blood stained fluid

Question 3

what is the most common cause of a pleural effusion?

Answer 3

pnuemonia infection- exudate

Question 4

if the PT is not asymptomatic, what symptoms may they experience?

Answer 4

• breathlessness

- pleuritic chest pain

Question 5

what are the signs of a pleural effusion?

Answer 5

• diminished breath sounds
• stony dullness to percussion
• bronchial breathing above effusion
• reduces chest expansion
• reduced vocal fremitus, resonance
• mediastinum may be displaced

Question 6

what features will be seen on an xray of pleural effusion?

Answer 6

• blunted costaphrenic angles

- fluid shadow

Question 7

what other investigation could be done ?

Answer 7

• aspirate fluid to take sample

Question 8

when would a pleural biopsy be done?

Answer 8

• if the aspirate was not diagnostic

Question 9

what are the treatments for pleural effusions?

Answer 9

• drainage

- pleurodesis

Question 10

where should an aspiration be taken from?

Answer 10

1-2 IC below where effusion percussed

Question 11

what is a pleurodesis?

Answer 11

where the 2 pleural layers are adhered together