pleural effusion

Question 1

definition

Answer 1

fluid in the pleural cavity space

it can be divided by protein conc and into transducate and exuadates

Question 2

blood
pus
lymph

Answer 2

haem
pyema
chyle

Question 3

difference between trans and exudates

Answer 3

<25g/l trans clearer on visual appearance the fluid

>35g/l exuadates

Question 4

a syndrome causing R sided p. effusion

Answer 4

meig syndrome

Question 5

symptoms

Answer 5

asymptomatic
dyspnoea
pleuritic chest pain
sob

Question 6

signs

Answer 6

decreased breathe sounds 
reduced tactil fremitus  and vocal resonance 
STONY DULL percussion 
reduced expansion 
shifted mediastinum on xray
on cxr- blunted cotrophrenic angles

Question 7

diagnosis

Answer 7

CXR
USs guided for drain

fluid sample -aspiration
biopsy

Question 8

treatment

Answer 8

drain using 21g needle

if transudate treat cause is ideal
pleurodesis - tal/ tetracycline
surgery
drainage

Question 9

causes of trans and exudates

Answer 9

transduates increase in:
CARIDAC: heart failure, fluid overload, pericarditis
hypoproteniama - cirrhosis, nephrotic syndrome, liver failure
hypothorydism meig syndrome

exudates can be increased due to infection- TB, pneumonia malignancy- carcinoma, mets, lymphoma
inflammation - granulomatous disease, RA, SLE,

Question 10

what can stop fluid being seen on xray?

Answer 10

< 300ml fluid
not upright
if in pneumothorax too may appear level

Question 11

other paremeter ranges

Answer 11

glucose <3.3
LDH o.6 up
ph <7.2

anti-nuclear body SLE
rh factor-RA
amylase- carcinoma, pancreattis bact pneumonia