Pleural effusion

Question 1

Describe a pleural effusion. (2)

Answer 1

A dysfunction of either increased production or decreased absorption of pleural fluid.

Question 2

Describe causes of a “failure of absorption” pleural effusion. (6)

Answer 2

Hypoproteinaemia (cirrhosis, nephrotic syndrome), congestive heart failure (increased venous pressure), lymphatic obstruction (cancer).

Question 3

Describe causes of an “overproduction” pleural effusion. (3)

Answer 3

Increased capillary permeability due to inflammation (infection, cancer, PE).

Question 4

Describe the signs and symptoms of pleural effusion. (9)

Answer 4

Breathlessness, chest pain, dyspnoea, tracheal deviation (away), reduced lung expansion, stony dull percussion note, quiet breath sounds, reduced vocal resonance.
Also symptoms relating to cause.

Question 5

Explain how pleural effusions could be bilateral or unilateral. (5)

Answer 5

Normally unilateral because most causes only happen in one lung like pneumonia, cancer, PE.
Can be bilateral because some things can be a cause in both like heart failure or nephrotic syndrome.

Question 6

Describe the differences between transudate and exudate pleural effusions. (8)

Answer 6

Transudate - low protein content - CHF, cirrhosis, nephrotic syndrome, PE.
Exudate - high protein content - malignancy, Pneumonia, TB, PE.

Question 7

Describe the treatments of a pleural effusion. (2)

Answer 7

Treat underlying condition.

If still severe, aspirate.