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Flashcards in Pleural Effusion Deck (13):
0

Light criteria?

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

1

Pleural fluid characteristics that suggests need for chest tube drainage?

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

4

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?

50 mL; 500 mL

5

Clear yellow pleural fluid suggests?

Frank pus?

Milky/turbid?

Dark green?

Transudate process

Infectious process/empyema

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

Biliothorax

6

Bloody pleural fluid strata?

50% hemothorax secondary to trauma, malignancy, PE

8

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

1500 mL; reexpansion pulmonary edema

9

Causes of transudative pleural effusions and radiographic features?

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

Signs of pleural effusion due to tuberculosis?

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

11

If chest tube is initially placed it is kept until?

Drainage rate has decreased to < 50 mL per day

12

Treatment of multiloculated empyema?

Fibrinolytic agents (streptokinase or urokinase) through the chest tube

13

Exudative pleural effusions: signs of connective tissue disease?

Low glucose
LDH >1000

14

Pleural effusion with Amylase suggests?

Pancreatitis or esophageal rupture

17

Indications for thoracentesis?

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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