Unilateral pleural effusion Flashcards
where does fluid accumulate
parietal & visceral pleura
underlying equation of pathophysiology of effusion
fluid production > fluid removal
cause of exudative vs transudative PE
- exudative –> capillaries inflammation causing fluid leaking to pleural space
- transudative –> too much fluid causing leakage to pleural space
is exudate PE likely to be unilateral or bilateral
unilateral
is transudative PE likely to be unilateral or bilateral
bilateral
protein content in exudative as opposed to transudative
high
LDH content in exudative PE compared to transudative
high
examples of exudative PE causes
- pneumonia
- TB
- lung cancer
- RA
- PE, trauma
- SLE
- mesothelioma
- lymphatic PE
examples of transudative PE causes
- HF
- cirrhosis
- nephrotic syndrome
- malabsorption/malnutrition
- meigs syndrome
what is meigs syndrome
- pleural effusion (oft right-sided)
- ovarian tumour
- ascites
percussion in effusion
dull
exacerbating factors of pleuritic chest pain in effusion
- inspiration
- cough
- movement
breath sounds in effusion
quieter
deviation in effusion
away
why is there reduced/absent sounds upon auscultation
fluid prevents transmission of sound waves
2 views required for diagnosing effusion in CXR
- PA
- L
findings in standing CXR in effusion
no costophrenic angle
findings in lying CXR in effusion
white layer over lung
when is thoracentesis/pleural effusion contraindicated
- INR>3
- HF
what type of effusion is present if the thoracentesis findings is clear, cloudy or white
- clear –> transudative
- cloudy –> exudate
- white –> lymphatic
when are the light criteria used to determine if effusion is exudate
protein 25-35
according to light’s criteria a pleural fluid/serum protein level above what is found in exudate
0.5
according to light’s criteria a pleural fluid/serum LDH level above what is found in exudate
0.6
according to light’s criteria a pleural fluid LDH above what is found in exudate
2/3 upper limit of normal
