Pleural effusions

Question 1

How to confirm pleural effusion

Answer 1

Pleural tap and take out sample

Question 2

What are the two main classifications for pleural efufsion

Answer 2

Transudate

Exudate

Question 3

what is transudate fluid

Answer 3

Effusions caused by factors which affect hydrostatic pressure, pleural permeability, and oncotic pressure

Question 4

What is exudate fluid

Answer 4

Changes to the local factors which influence the formation and absorption of pleural fluid

Question 5

What causes transudate effusions

Answer 5

Congestive heart failure
liver cirrhosis
Nephrotic syndrome

Question 6

What causes exudate effusions

Answer 6

Malignancy
Infection
Pulmonary embolus

Question 7

How to classify effusions

Answer 7

Protein concentration in fluid:
<30g/L is transudate
>30g/L is exudate

Question 8

Symptoms

Answer 8

SOB
Cough
Pleuritic chest pain

Question 9

Findings which suggest effusion

Answer 9

Percussion dull

Breath sounds quieter

Question 10

How to investigate

Answer 10

Resp exam
CXR (blunting of costophrenic and cardiophrenic angles, potential mediastinal shift)
Ultrasound is the most sensitive imaging modality to detect or estimate pleural fluid volume

Question 11

Complication of pleural effusion

Treatment

Answer 11

Empyema (infection)

Drainage and abx

Question 12

Investigation for a unilateral pleural effusion

Answer 12

Pleural tap and do a bronchoscopy to get a biopsy to see if there is a malignant cause