Pleural Effusion

Question 1

Exudative causes

Answer 1

• Lung cancer
• Pneumonia
• RA
• TB

Question 2

Definition of pleural effusion

Answer 2

• Collection of fluid in the pleural cavity

Question 3

Transudative causes

Answer 3

• HF
• Hypoalbuminaemia
• Hypothyroidism
• Meig’s syndrome (right sided pleural effusion with ovarian malignancy)

Question 4

Presentation of pleural effusion

Answer 4

• SOB
• Dullness to percussion over effusion
• Reduced breath sounds
• Tracheal deviation away from the effusion if it’s massive

Question 5

Investigation of pleural effusion

Answer 5

• CXR
  
  • Blunting of the costophrenic angle
  • Fluid in the lung fissures
  • Larger efusions will have a meniscus
  • Tracheal and mediastinal feviation if massive efusion

Question 6

Treatment of pleural effusion

Answer 6

• Conservative
  
  • May be appropriate in small effusions and will resolve with treatment of underlying cause
• Pleural aspiration
• Chest drain (if recurrent)

Question 7

Empyema

Answer 7

• Infected pleural effusion
• Pleural aspiration shows and acidic pH, low glucose and high LDH
• Requires a chest drain and antibiotics

Question 8

Transudate vs Exudate

Answer 8