Pleural Effusion

Question 1

What is meant be transudate pleural effusion?

Answer 1

<30g/L protein

Question 2

What is meant be exudate pleural effusion?

Answer 2

> 30g/L protein

Question 3

What are the causes of transudate pleural effusion?

Answer 3

*heart failure (most common transudate cause)

*hypoalbuminaemia
>liver disease
>nephrotic syndrome
>malabsorption)

*hypothyroidism

Question 4

What are the causes of exudate pleural effusion?

Answer 4

• pneumonia (most common exudate cause)
• TB
• subphrenic abscess
• connective tissue disease: RA, SLE
• neoplasia: lung cancer, *mesothelioma, metastases
• pancreatitis
• pulmonary embolism
• Dressler’s syndrome

Question 5

What are the clinical features of pleural effusion?

Answer 5

• Dyspnoea
• non-productive cough
• chest pain
• Dull to percuss
• reduced breath sounds
• reduced chest expansion

Question 6

What investigations should be done in suspected pleural effusion?

Answer 6

• CRX
• USS when pleural aspiration considered
• CT Chest to investigate underlying cause

Question 7

What is the management of a pleural effusion?

Answer 7

• USS guided pleural aspiration using 21G needle and 50ml syringe
• fluid sent for pH, protein and lactate, cytology, micobiology