pleural effusion + pneumothorax Flashcards
(28 cards)
what is a pleural effusion
abnormal collection of fluid in pleural space
what is transudate pleural effusion
<30g/l
causes transudate pleural effusion
heart failure // hypoalbumin (liver, nephrotic syndrome, malabsorption) // hypothyroid // Meigs (ovarian tumour + effusion + ascites)
what is exudate pleural effusion
> 30g/l
causes exudate pleural effusion
pneumonia!!! TB // RA or SLE // lung cancer // PE // pancreatitis // dresslers
features pleural effusion
SOB // cough or chest pain // dull to percuss // reduced breath sounds // reduced chest expansion
imaging pleural effusion
PA CXR // USS // CT
finding CXR pleural effusion
○ Blunting of costophrenic angle
○ Fluid in lung fissures
○ D sign meniscus
how is pleural aspiration carried out
USS // 21G needle
what criteria is used for transudate vs exudate pleural effusion
lights criteria
what features of aspiration make exudate pleural effusion more likely
fluid protein/ serum protein >0.5 // pleural LDH more than 2/3 of normal serum LDH
low glose pleural effusion
RA or TB
raised amylase pleural effusion
pancreatitis, oeseophageal rupture (+ acidosis)
what indicates empyema
cloudy // pH <7.2 (insert chest drain) // low glucose
mx recurrent pleural effusion
recurrent aspiration // pleural catheter // pleurodesis // opioids for SOB
RF pneumothorax
tall, young thin man // lung disease // marfans RA // ventilation // endometriosis or menstruation
symptoms pneumothorax
SOB // pleuritic chest pain // sweating // fast HR, RR
invx pneumothorax
CXR = no lung signs in periphery
what causes a tension pneumothorax
following trauma // rising pressure
features tension pneumothorax
trachea shifts // hyper-resonance on affected side
mx primary pneumothorax <2cm + asymptomatic
no mx required
mx primary pneumothorax >2cm
aspiration
when is aspiration indicated in secondary pneumothorax
air rim 1-2cm
when is chest drain indicated secondary pneumothorax
> 50 and >2cm air
