Pleural Effusion Flashcards Preview

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Flashcards in Pleural Effusion Deck (13)
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0
Q

Pleural fluid characteristics that suggests need for chest tube drainage?

A
  1. Empyema (pus in plural space)
  2. Positive Gram stain
  3. Loculation
  4. PH 1000
1
Q

Light criteria?

A

For fluid to be labeled exudate must meet one of these criteria:

  1. Pleural Protein/serum protein >.5
  2. Pleural LDH/serum LDH >.6
  3. Pleural LDH >2/3 normal serum LDH
4
Q

Amount of fluid needed in order to be visible on the lateral decubitus film? Amount of fluid needed to obscure entire hemidiaphragm on x-ray?

A

50 mL; 500 mL

5
Q

Clear yellow pleural fluid suggests?

Frank pus?

Milky/turbid?

Dark green?

A

Transudate process

Infectious process/empyema

Chylothorax triglycerides >110 resulting from disruption thoracic duct or Cholesterol effusions

Biliothorax

6
Q

Bloody pleural fluid strata?

A

50% hemothorax secondary to trauma, malignancy, PE

8
Q

How much fluid can be safely removed in a therapeutic thoracentesis? Risk if more than this amount is removed?

A

1500 mL; reexpansion pulmonary edema

9
Q

Causes of transudative pleural effusions and radiographic features?

A
  1. CHF – bilateral/symmetric or right-sided effusion
  2. Nephrotic syndrome – bilateral and subpulmonic effusions
  3. Cirrhosis – patients also have ascites
  4. Malignancy – obstructed lymphatics
  5. PE
  6. Hypothyroidism
10
Q

Signs of pleural effusion due to tuberculosis?

A

Lymphocytes >80%
Adenosine deaminase >43
Protein > 4
< 10% acid-fast bacilli

11
Q

If chest tube is initially placed it is kept until?

A

Drainage rate has decreased to < 50 mL per day

12
Q

Treatment of multiloculated empyema?

A

Fibrinolytic agents (streptokinase or urokinase) through the chest tube

13
Q

Exudative pleural effusions: signs of connective tissue disease?

A

Low glucose

LDH >1000

14
Q

Pleural effusion with Amylase suggests?

A

Pancreatitis or esophageal rupture

17
Q

Indications for thoracentesis?

A
  1. Uneven/unilateral pleural effusion
  2. Evidence of infection (productive cough, fever)
  3. Normal cardiac silhouette
  4. Alarming signs: weight loss, hemoptysis, hypoxia

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