Pleural Effusion Flashcards

1
Q

What are the findings in a respiratory exam in a person with a pleural effusion?

A

Tracheal Deviation
Decreased expansion
Stony Dull percussion note
Diminished breath sounds

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2
Q

What is the normal pH of the pleural fluid?

A

7.6

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3
Q

What is the pH of an infected effusion?

A

<7.2

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4
Q

In what conditions is the glucose levels in the pleural aspirate low?

A
Empyema
Rheumatoid 
Lupus
TB
malignancy
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5
Q

Chest X-ray findings

A

Blunting of costophrenic angles with ‘white-out’

Meniscus- fluid level

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6
Q

Light’s Criteria

A

Pleural fluid with a protein concentration 25-35 g/L. Exudate If:
Fluid/serum protein of >0.5 OR
Fluid serum lactate dehydrogenase >0.6 OR
Fluid lactate dehydrogenase >2/3 the upper limit of normal serum

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7
Q

Causes of transudate effusions

A
Heart failure
Hepatic failure
Renal failure
Hypothyroidism
Pulmonary embolus
Meig's syndrome
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8
Q

Causes of exudate effusions

A
Malignancy
Infection
Rheumatoid disease
TB
Empyema
Sarcoidosis
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9
Q

What is an empyema?

A

Collection of pus within the pleural cavity

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10
Q

What causes an empyema?

A
Complication of thoracic surgery
Rupture of lung abscess into the pleural space
Perforation of oesophagus
Mediastinitis
Bacterial spread of pneumonia
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11
Q

Aspirate fluid in empyema

A

Yellow and turbid
<7.2
Low glucose
Increased LDH

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12
Q

Management of empyema

A

Chest drain inserted under radiological guidance

Antibiotic treatment

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13
Q

Management of the pleural effusion

A

If symptomatic- drain 0.5-1.5L/24hour

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14
Q

How to aspirate a pleural effusion?

A

Percuss the upper border of the pleural effusion and choose 1/2 intercostal spaces below it.
5-10 ml of 1% lidocaine
21G to a syringe and and insert above the upper border of an appropriate rib
Draw off 10-30ml of pleural fluid

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