Pleural Effusion and Empyema

Question 1

What is the difference between a pleural effusion and an Empyema?

Answer 1

Infection

Question 2

Where does fluid accumulate in a pleural effusion?

Answer 2

The visceral and parietal pleura

Question 3

What kind of lung disease are pleural effusions and Empyema?

Answer 3

Restrictive Lung Disorder

Question 4

What are the major pathologic or structural changes associated with significant pleural effusion?

Answer 4

Lung compression, atelectasis, compression of the great veins and decreased cardiac venous return

Question 5

What kind of fluid is thin and watery, containing a few blood cells and little protein?

Answer 5

Transudative

Question 6

What kind of fluid is caused by inflammation, infection, or malignancy?

Answer 6

Exudative

Question 7

What kind of pleural effusion develops when fluid from the pulmonary capillaries moves into the plural space?

Answer 7

Transudative Pleural Effusion

Question 8

What kind of fluid develops when the pleural surfaces are diseased?

Answer 8

Exudative Pleural Effusion

Question 9

How many people are approximately affected by Pleural Effusions each year in the United States?

Answer 9

1.3 million

Question 10

What are some early signs and symptoms of a pleural effusion?

Answer 10

Pleuritic chest pain, “chest pressure” dyspnea, and cough

Question 11

What are some common causes of a transudative pleural effusion?

Answer 11

CHF, hepatic hydrothorax, peritoneal dialysis, nephrotic syndrome, PE or infarction

Question 12

What is the most common cause of pleural effusion?

Answer 12

CHF

Question 13

In Cor pulmonale, what causes an increase in the hydrostatic drainage in the systemic circulation?

Answer 13

1.) increase the rate of pleural fluid formation and 2.) decrease lymphatic drainage from the pleural space because of the elevated SVP

Question 14

In CHF, what causes an increase in hydrostatic pressure in the pulmonary circulation?

Answer 14

1.) decrease the rate of pleural fluid absorption through the visceral pleura and 2.) cause fluid movement through the visceral pleura into the pleural space

Question 15

How does a pulmonary embolism cause a pleural effusion?

Answer 15

1.) obstruction of the pulmonary vasculature can lead to right sided heart failure 2.) ischemic infarction caused by a PE increases the permeability of the capillaries in the visceral pleura

Question 16

What are some common causes of exudative pleural effusions?

Answer 16

Malignant pleural effusions and mesotheliomas, bacterial pneumonias, tuberculosis, fungal diseases, diseases of the gastrointestinal tract, collagen vascular diseases

Question 17

What is a hemothorax?

Answer 17

The presence of blood in the pleural space

Question 18

What are some clinical manifestations of pleural effusion obtained at the bedside?

Answer 18

Chest pain, decreased chest expansion, cyanosis, cough, tracheal shift, dull percussive note

Question 19

What are the radiologic findings on a chest radiograph for pleural effusion?

Answer 19

Blunting of the costophrenic angle, fluid level on the affected side, depressed diaphragm, mediastinal shift to the unaffected side, atelectasis, “meniscus sign”

Question 20

What are the respiratory care treatment protocols for pleural effusion?

Answer 20

Oxygen therapy, lung expansion, mechanical ventilation, and pleurodesis