pleural effusion Flashcards
what is it
excessive accumulation of fluid in pleural space
when can it be detected on chest x-ray
> 300mL of fluid
when can it be detected clinically
> 500mL
what is seen on chest x-ray
- obliteration of the costophrenic angle
- dense homogeneous shadows
what can fluid below lung stimulate
a raised hemidiaphragm
diagnosis
pleural aspiration
what is aspiration done with
ultrasound
what are the 2 types
- transudate
- exudate
causes of transudate
- heart failure
- liver failure
- kidney failure
- ovarian tumours
- hypothyroidism
where are transudates usually larger.
right side
what is protein content in transudate
<30g/L
what is protein content of exudates
> 30g/L
causes of exudate
- pneumonia
- carcinoma of bronchus
- TB
- post MI
- mesothelioma
- sarcoidosis
how is diagnosed if aspiration is not established
pleural biopsy
treatment
treat underlying condition unless fluid is purulent
what is treatment if fluid is purulent
drainage
what is management of malignant pleural effusion
aspirate to dryness followed by instillation of a sclerosing agent such as tetracycline or talc
how should effusions be drained
slowly since rapid shift of mediastinum causes severe pain
does treatment of malignant pleural effusion long term
no it is only temporary
