Pleural Effusion Flashcards
what are the two main mechanisms for forming pleural effusion
increased pleural fluid formation
decreased pleural fluid clearance
what are some causes for increased pleural fluid formation
inflammation - leaky vessels
increased pulmonary venous pressure
decreased plasma oncotic pressure
decreased pleural pressure
what are some mechanisms that decrease pleural fluid clearance
blockage/obstruction/compression
increased systemic venous pressure (lymp drains to venous, backpressure would reduce this)
limited respiratory motion
presentation of pleural effusion
SOB
dull to percuss
decreased chest expansion on the effected side
decreased breath sounds on affected side
what can you see on CXR for pleural effusion
blunting of costophrenic angle
opacification
meniscial sign
what is gold standard for diagnosis of pleural effusion
USS + thoracocentesis
what is lights criteria
sets out that to be an exudative effusion it must have one of the following:
1. pleural protein: serum protein >0.5
2. pleural LDH: Serum LDH >0.6
3. pleural LDH more than 2/3rds of the upper normal limit of serum LDH
what are the causes of transudate pleural effusion
CHF
liver cirrhosis
nephrotic syndrome
what are causes of exudative pleural effusion
inflammation
infection
injury
tumour
pancreatitis
drug induced
PE
CTD
what is the general management for pleural effusion
manage underlying cause
thoracocentesis
chest drains
pleurodesis
pleurectomy
