Pulmonary Effusion

Question 1

What can pulmonary effusions be classified into?

Answer 1

either being a transudate or exudate according to the protein concentration

Question 2

It is a Transudate pulmonary effusion if?

Answer 2

<30g/L protein

Question 3

It is an Exudate pulmonary effusion if?

Answer 3

> 30g/L protein

Question 4

Transudate pleural effusion causes?

Answer 4

• heart failure (most common transudate cause
• hypoalbuninaemia due to:
  
  • liver disease
  • nephrotic syndrome
  • malabsorption
• hypothyroidism
• Meig’s syndrome

Question 5

Transudate pleural effusion causes?

Answer 5

• heart failure (most common transudate cause
• hypoalbuninaemia due to:
  
  • liver disease
  • nephrotic syndrome
  • malabsorption
• hypothyroidism
• Meig’s syndrome

Question 6

Which ratio can you use to classify pleural effusion of exudate

Answer 6

> 0.5

Question 7

Features of pleural effusion

Answer 7

dyspnoea

non-productive cough or chest pain are possible

classic examinations: dullness to percussion, reduced breath sounds, reduced chest expansion

Question 8

How does a pulmonary embolism cause an exudative pleural effusion?

Answer 8

By forcing fluid out of the lung interstitium (space between the alveoli and capillary) into the pleural space

This occurs as a result of ischaemia caused by the pulmonary embolus

The interstitial fluid contains proteins and so, therefore, increases the protein concentration in the pleural fluid, consequently increasing the fluid protein/serum protein ratio

Question 9

If a pleural effusion is drained too quickly, a rare but important complication is?

Answer 9

re-expansion pulmonary oedema

it presents with breathlessness.

it is unlikely the pleural fluid would re-accumulate that quickly over the course of a few hours to cause new breathlessness