pleural effusion

Question 1

what is pleural effusion

Answer 1

accumulation of fluid in the pleural cavity

above the normal amount 10 -20ml

Question 2

what is the aetiology ?

Answer 2

congestive heart failure - due to increase capillary hydrostatic pressure

pneumonia - ultered permeability of pleural membranes

cirrhosis / ascitis - reduction in oncotic pressure

Question 3

what is the classification of pleural effusion ?

Answer 3

acute and chronic

transudate / exudate
transudate - not inflammtory - fluid leaking , increase blood pressure (oncotic and hydrostatic pressure imbalance)

exudate - due tp tubeculosis , pe , pancreatitis , uremia , chylothorax -Triglycerdies n the pleural fluid - because of thoracic duct rupture

exudates contain - inflammtory infiltrate

Question 4

what do you see clinically pleural effusion ?

Answer 4

fever
dyspnea
chest pain

Question 5

what is the diagnosis of pleural effusion

Answer 5

chest x ray -
HRCT -

thrococentesis - analyse it
distinguishing whether it is exudate or transudate
light criteria
fluid is exudate - ratio of the pleural fluid to the serum (blood) is greater than 0.5
ratio of pleural fluid serum ldh - lactase dehydrogenase greater than 0.6
pleural fluid ldh greater than 2/3 of the upper limit of the normal value

transudate -if you don’t see any of that

LIGHTS CRITERIA
exudate:
pleural fluid greater than the upper limit of the normal serum
pleural fluid cholesterol greater than 45mg/dl
pleural fluid protein fluid greater than 2.9g/dl

contraindication - chest wall cellulitis and coagulaopathy

complication - pneumothorax , hemothroax (more than 50 percent blood hematocrit in the pleural cavity) empyema