Pleural effusion Flashcards
What is pleural effusion?
Fluid collection in pleural space
What are the types of pleural effusion?
Transudative <30g/l protein
Exudative >30g/l
What causes transudative pleural effusion?
Heart failure= most common
Hypoalbuminaemia- liver disease, nephrotic syndrome, malabsorption
Hypothyroid
What causes exudative pleural effusion?
Infection- pneumonia= most common, TB PE Neoplasia Connective tissue disease- RA, SLE Pancreatitis
What is the common presentation of pleural effusion?
SOB
Dullness to percussion
features of cause
What is the less common presentation of pleural effusion?
Pleuritic chest pain
Non productive cough
Decreased breath sounds
What investigations are done for pleural effusion?
CXR
Pleural US
Pleural tap
What is seen on CXR with pleural effusion?
Blunting of costophrenic angle, fluid in tissues
Meniscus sign
Massive= tracheal and mediastinal shift
When is pleural effusion visible on CXR?
50-200mls fluid
Why i pleural US useful?
Can identify 5-10mls pleural effusion
What is looked at in the pleural aspirate?
pH, glucose, protein, LDH, cytology, microbiology
What investigations should be considered with pleural effusion?
CT/MRI
What is the management principle of pleural effusion?
Dependent on cause
Treat cause, and pleural aspiration/chest drain
What are the common complications of pleural effusion?
Lobal collapse
Pleural fibrosis
Empyema
What is empyema?
Infected pleural effusion
