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  • Pleural Effusion

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    fahad nokia
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    A 59 year old man presents with breathlessness and is examined for signs of a pleural effusion on the respiratory system. On examination of the side of the effusion, signs include reduced expansion, reduced breath sounds, reduced vocal resonance, and dullness to percussion. Additional signs note cachexia, previous chest drain marks, evidence of an underlying cause such as clubbing or tar staining. Common discussion topics for pleural effusions include the differential diagnosis, Light's criteria to determine if the effusion is an exudate or transudate, causes of each, recommended investigations including blood gas analysis, chest X-ray, ultrasound and fluid analysis, and management options.

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    effusion

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    A 59 year old man presents with breathlessness and is examined for signs of a pleural effusion on the respiratory system. On examination of the side of the effusion, signs include reduced expansion, reduced breath sounds, reduced vocal resonance, and dullness to percussion. Additional signs note cachexia, previous chest drain marks, evidence of an underlying cause such as clubbing or tar staining. Common discussion topics for pleural effusions include the differential diagnosis, Light's criteria to determine if the effusion is an exudate or transudate, causes of each, recommended investigations including blood gas analysis, chest X-ray, ultrasound and fluid analysis, and management options.

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    © All Rights Reserved
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    33 views1 page

    Pleural Effusion

    Uploaded by

    fahad nokia
    A 59 year old man presents with breathlessness and is examined for signs of a pleural effusion on the respiratory system. On examination of the side of the effusion, signs include reduced expansion, reduced breath sounds, reduced vocal resonance, and dullness to percussion. Additional signs note cachexia, previous chest drain marks, evidence of an underlying cause such as clubbing or tar staining. Common discussion topics for pleural effusions include the differential diagnosis, Light's criteria to determine if the effusion is an exudate or transudate, causes of each, recommended investigations including blood gas analysis, chest X-ray, ultrasound and fluid analysis, and management options.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Pleural Effusion:

    Please examine the Respiratory System of this 59 year old man who presents
    with breathlessness.

    Clinical Examination:

    Classical Signs Additional Signs

    On the side of the effusion: - Cachexia


    - Reduced expansion - Aspiration/chest drain marks
    - Reduced breath sounds - Evidence of cause: clubbing, tar
    - Reduced vocal resonance staining, lymphadenopathy,
    - Dullness to percussion previous mastectomy, peripheral
    oedema (Heart Failure)
    - Tracheal deviation to opposite
    side

    Common discussion topics:

    - Differential diagnosis
    - Light’s criteria
    - Causes of a transudate and exudates
    - Investigations
    - Management

    Quick Revision:

    Investigations Lights Criteria

    ABG to assess hypoxia An exudate if one or more of these is true:


    Chest Xray – fluid level
    USS to aid with aspiration Pleural fluid protein:serum protein > 0.5
    Pleural aspirate to determine whether Pleural fluid LDH:serum LDH >0.6
    exudate or transudate, send fluid for Pleural fluid LDH > 2/3 upper limit of
    culture and cytology normal serum LDH
    Stagin CT if neoplasm considered
    Vasculitic screen may be considered

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