Respiratory 8 - Pleural Effusion

Question 1

define pleural effusion

Answer 1

collection of fluid in the pleural cavity

Question 2

differentiate the 2 types of pleural effusion

Answer 2

exudative protein >3g/L

transudative protein <3g/L

Question 3

4 main causes of exudative pleural effusion and their link

Answer 3

inflammatory conditions

pneumonia
lung cancer
rheumatoid arthritis
tuberculosis

Question 4

4 transudative causes of pleural effusion and their link

Answer 4

fluid shifts

heart failure
hypoalbuminaemia
hypothyroidism
chronic kidney disease

Question 5

1 symptom, 3 signs of pleural effusion

Answer 5

short of breath
dull to percuss over effusion
reduced breath sounds that side
tracheal deviation away from effusion

Question 6

4 pleural effusion chest x ray signs

Answer 6

blunting of CP angle
fluid in the fissures
meniscus if large
mediastinal deviation if very large

Question 7

what do you see on a pleural tap result? (don’t learn, just so aware(

Answer 7

protein count, cell count, pH, glucose, LDH, culture

Question 8

3 potential methods of managing pleural effusion

Answer 8

(obviously deal with any known cause)

conservative if small
pleural tap
chest drain

Question 9

explain what an empyema is and when you might suspect it

Answer 9

empyema = infected pleural effusion

suspect if the pneumonia had been improving but they have a new or persistent fever

Question 10

pleural tap with empyema

Answer 10

pus, acidic pH <7.2, low glucose, high LDH

give chest drain and Abx