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15 Cards in this Set

  • Front
  • Back
Pleural Effusion
Pleural effusion is an abnormal accumulation of fluid and is often detectable on plain chest film
5 major types of pleural effusion
- exudate
- empyema
- transudate
- hemothorax
- chylothorax
Exudate: formed by an active abnormal protein.
.5 of pt protein of same pt
.6 LDH of same pt
LDH content 2/3the upper limit
of normal serum
Causes of Exudate
Various INFX:
TB, Fungus/parasite
(Pneumo, bact or viral,
Cancer)most common
Passive movement of fluid
Resulting from:
- increased vascular hydrotstatic pressure
- decreased plasma oncotic pressure
- increased negative intrapleural pressure
Causes of Transduate:
accounts for 90% of transudates and is the most common cause of pleural effusion overall. Left ventricular failure causes pressure to increase in the pulmonary vessels ----->
increased hydrostatic pressure.
REMINDER:CHF s a syndrome
which results from one or more of the various causes of heart pathology,
i.e. cardiomyopathy, valvular disease, infarction
2.Nephrotic Syndrome
decreased plasma oncotic pressure
3.Constrictive pericarditis
noncompliant pericardium restricts ventricular filling and mimics CHF
4.Acute atelectasis
increased negative intrapleural pressure
- Pulmonary embolism  inc’d Pul.Vasc. Resistance  inc’d hydro-
static pressure  transudate
a form of exudate. Fluid is turbid or purulent due to infection in the pleural space itself.
gross blood in pleural space. Usually due to chest trauma.
milky in appearance due to presence of cholesterol complexes.most common in tuberculous pleuritis or rheumatoid
pleuritic chest pain (pain with breathing not due to fractured rib) effusion is usually exudative.
if pleural friction rub -> indicates pleurisy.
SMALL EFFUSIONS:usually asymptomatic.
may compress.
dullness to percussion lung.
dullness to percussion.
Massive effusion on one side may push the trachea(and therefore the tracheal air column)to the opposite side.
blunting of the costophrenic sulcus (or angle ) due to fluid accumulation there.
“Thickening” of interlobal and/or interlobular lung fissures on plain film.
Crescentic line or meniscus: When an effusion is large enough, it fills the pleural space from the lung base toward the lung apex, so the affected hemithorax appears as a large white opacification on the Xray