Pleural effusion

Question 1

Types of pleural effusion

Answer 1

Transudative and exudative

Question 2

Causes of transudative pleural effusion (4)

Answer 2

1. Heart failure
2. Liver failure
3. Nephrotic syndrome
4. Hypothyroidism

Question 3

Causes of exudative pleural effusion (4)

Answer 3

1. Infection
2. Malignancy
3. Connective tissue disease
4. Pancreatitis

Question 4

Light’s criteria for diagnosing transudative pleural effusion

Answer 4

• Pleural fluid:serum protein >0.5
• Pleural fluid:serum LDH >0.6
• Pleural fluid LDH >0.7 (2/3)

Question 5

Signs of pleural effusion (6)

Answer 5

1. Reduced expansion
2. Stony dull percussion
3. Decreased vocal resonance
4. Decreased breath sounds
5. Bronchial breathing
6. Pleural rubs

Question 6

Signs of pleural effusion on CXR (3)

Answer 6

1. Meniscal sign
2. Blunting of costophrenic angles
3. Air-fluid level (pneumothorax)

Ix: you would also do an ultrasound-guided aspiration for cytology and biochemistry.

Question 7

Management of pleural effusion

Answer 7

Drainage. Pleurodesis if severe.