Pleural Disease Vignettes Flashcards Preview

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Flashcards in Pleural Disease Vignettes Deck (11):

Transudative pleural fluid formula

Due to extra-pleural

Heart failure, cirrhosis, hypoalbulinemia, neophrotic syndrome


Pleural effusions due to CHF

81% bilateral but may not be equal in size


Bacteiral pneumonia to empyema

May look for high LDH with low pH

Manage with a chest tube


CHF and Nephrotic syndromes produce

Trnasudative effusions but have predisposition to pulmonary thromboembolism


Important of treating pleural infection adequately

Can result in fibrothorax with trapped lung and restrictive impairment


PE protocl

Give therapeutic heparin (unless contraindiciation) while awaiting dx testing


TB effusions

Lymphocytic exudates...think over 90%

Cancer, TB, lymphoma or chylous effusion

TB stain does not need to be positive

Pleural TB is non-communicable but parenchymal is


Thumatoid effusion

More in males

80% have subq nodules

Unilateral in most

May mimiic empyema with low glucose, low pH and high LDH

Alos look for tadpole-shaped histiocytes and giant cells


PLeural plaques vs. late dz

Plauqes at supradiaphragmatic means exposure

Late - lung cancer and mesothelioma

Mesothelioma has a 25-45 year lag time


Malignant meso

25-45 year lag

Chest pain and dyspnea

Progressive pleural dz

May be intraperitoneal

Need open biopsy


Chylous effusion

Due to disruption of thoracic duct

Milky, high protein, lymphocytic with chylomicrons

Most common etiology is tumor (lymphoma) although could be TB

May mimic empyema but empyema should be neturophil prdom without chylomicrons