Types of Pleural Effusion

Question 1

What are the types of pleural effusion?

Answer 1

Pure Transudate
Modified Transudate
Exudate

Question 2

Which category is pyothorax?

Answer 2

Septic exudate

Question 3

Which category is chylothorax?

Answer 3

Chyle exudate

Question 4

Describe pure transudate

Answer 4

Extravascular filtrate of protein and cell poor fluid
Low cellularity
Low protein
Clear in colour

Question 5

Describe modified transudate

Answer 5

Extravascular filtrate but higher in protein
Moderate cellularity (but lower than exudate)
Moderate protein (25-40g/l)
Hazy in colour

Question 6

What are the types of exudate?

Answer 6

Non-septic (inflammatory/serous)
Septic (infectious/purulent)
Blood (haemorrhagic)
Chyle
Fibrinous

Question 7

Describe exudate

Answer 7

Extravascular fluid with high protein and implies an inflammatory response
Typically opaque
Protein >30g/l
Moderate-high cell count

Question 8

Describe pyothorax fluid

Answer 8

Amber/yellow colour
High in protein
High in cells
Smelly
PUS!

Question 9

Describe chylothorax

Answer 9

Cream/pink colour
High in cells
Variable protein

Question 10

How is transudate formed?

Answer 10

Extravascular filtrate of protein and cell poor fluid
Caused by increased hydrostatic pressure/decreased colloid-osmotic pressure

High pressure forces fluid out of capillaries
Low colloid-osmotic pressure means low protein so needs less fluid (fluid follows solids)

Question 11

Causes of increased hydrostatic pressure

Answer 11

Venous outflow obstruction
E.g. Congestive heart failure

Question 12

Causes of decreased colloid osmotic pressure

Answer 12

Decreased protein synthesis
E.g. Liver disease
Protein losing enteropathy
E.g. kidney disease/gut disease

Question 13

How is exudate formed?

Answer 13

Extravascular fluid with high protein conc and contains blood cells
Implies presence of inflammation

Result of increased microvascular permeability which is a result of inflammation
Allows active transport of protein and leucocytes