pleural effusion

Question 1

classification of pleural effusion

Answer 1

transudate, too much fluid leaving capillaries (hydrostatic or oncotic pressure problem) usually <30g/L protein
or
Exudate, cuz of inflammation of pulmonary capillaries usually >30g/L

Question 2

how do you get pleural effusion with pneumonia

Answer 2

Following a pneumonia, some patients develop a free-flowing exudate (parapneumonic effusion) that may become infected when there is bacterial invasion across the damaged lung epithelium. In the presence of pus, this effusion is termed an empyema, and is characterised as having a pH <7.2, a low glucose (<3.4 mmol/L), and a high LDH (>200 IU/L or 2-3 times above upper limit of normal range for serum).

Question 3

causes of exudate pleural effusion

Answer 3

infection: pneumonia (most common exudate cause), TB, subphrenic abscess
connective tissue disease: RA, SLE
neoplasia: lung cancer, mesothelioma, metastases
pancreatitis
pulmonary embolism
Dressler’s syndrome
yellow nail syndrome

Question 4

causes of transudate pleural effusion

Answer 4

heart failure (most common transudate cause)
hypoalbuminaemia (liver disease, nephrotic syndrome, malabsorption)
hypothyroidism
Meigs’ syndrome

Question 5

how to treat pleural effusion

Answer 5

HF - diuretics and sodium restiriction

large effusion from cancer, drain

large from infection surgery to avoid empyema