Pleural effusion

Question 1

what is a pleural effusion

Answer 1

excessive accumulation of fluid in the pleural space

Question 2

give some risk factors for developing a pleural effusion

Answer 2

congestive HF, malignancy, pneumonia, recent CABG surgery

Question 3

what are the symptoms of a pleural effusion

Answer 3

cough, dyspnoea, pleuritic chest pain

Question 4

what are the signs of a pleural effusion

Answer 4

quieter breath sounds, dullness to percussion

Question 5

what 2 different types of fluid accumulate in a pleural effusion

Answer 5

transudate or exudate liquid

Question 6

describe the features of transudates

Answer 6

protein content <30g/L, and lactate dehydrogenase(LDH) < 200IU/L

Question 7

describe the features of exudates

Answer 7

protein content > 30g/L and LDH > 200 IU/L

Question 8

how are pleural effusions typically diagnosed

Answer 8

by pleural aspiration, usually by ultrasound guidance

Question 9

what are some causes of a transudate pleural effusion

Answer 9

HF, constrictive pericarditis, hypothyroidism

Question 10

what are some causes of exudate pleural effusions

Answer 10

bacterial pneumonia, bronchial carcinoma, PE

Question 11

describe the management of a normal pleural effusion

Answer 11

management of underlying condition, unless fluid is purulent(empyema) in which case must be drained

Question 12

describe the management of a malignant pleural effusion, i.e. one that reaccumulates and is symptomatic

Answer 12

aspirated to dryness(slowly) followed by installation of sclerosing agent, e.g. tetracycline
(short term relief)