Pleural Effusions Flashcards
what is a pleural effusion?
an excessive accumulation of fluid in the pleural space
symptoms of a pleural effusion?
- chest pain
- dry, non-productive cough
- dyspnoea/shortness of breath
- orthopnea (inability to breathe unless the patient is sitting up straight or standing erect)
what are the 2 types of pleural effusion?
1) transudate pleural effusions
2) exudate plural effusions
describe the protein content in transudate pleural effusions
= one that has a LOWER PROTEIN CONTENT.
protein < 30g/L
what sort of problems cause transudate pleural effusion?
systemic problems
Examples;
- heart failure
- liver cirrhosis
describe the protein content in exudate pleural effusion
= one that has a HIGHER PROTEIN CONTENT
protein > 30g/L
what causes exudate pleural effusions?
- caused by pleural diseases.
Examples;
- malignancy
- infection, bacterial pneumonia
- pulmonary infarct
how would you diagnose a pleural effusion?
1) chest X-ray
2) routine blood tests
3) aspiration of pleural fluid
4) cytology & cell counts
what would a chest X-ray show?
- it is detected on X-ray when there is >300ml of fluid present.
what 2 specific things would you test for in the blood test?
1) rheumatoid factor
2) tumour markers
when you aspirate the pleural fluid what are you going to measure?
1) protein content
= transudate
= exudate
2) LDH
3) glucose concentration
4) pH
when you are testing the pH from the pleural aspirate what does a pH < 7.3 suggest?
pH < 7.3
= suggests pleural inflammation
when you are testing the pH from the pleural aspirate what does a pH < 7.2 suggest?
pH < 7.2
= requires drainage in the setting of infection
what cells are you looking for during a cell count?
1) malignant cells
2) lymphocytes
3) neutrophils
How would you treat a pleural effusion?
1) pleural drainage
= to remove a large quantity of fluid
