Which of the following will not present in pleural effusion-
Correct Answer: Hyper resonance in affected side
Description: (B) Hyperresonance in affected side (643, 659 Davidson 21st) (2178-80- H 18th)PLEURAL EFFUSIONINSPECTIONPERCUSSION* Bulging of the intercostal space* Stony dullness with increased resistance and no shifting dullness below the level of fluid* Diminished mobility of the chest wall on the affected side* Skodiac resonance (boxy note) just above the effusion* Shift of the mediastinum to the opposite side i.e. Trailes sign* Obliteration ofTroube's space if left sided effusion* Tachypnoea* Grocco's triangle: Triangular area of dullness against the vertebral column at the base of the opposite lung due to collapse of the lung.Ausculation:* Absent breath sound or diminished, below the level of effusion.* Bronchial breathing at the level of pleural effusion due to relaxed lung.* Vocal resonance at the base* Crackles above effusion* Aegophony at the level of the pleural effusion* Diminished or absent vocal fremitus below the level of the fluid.* Around 200ml of fluid is required to be detectable on a PA chest X-ray.* Ultrasound is more accurate than plain chest X-ray* Pleural effusion is an exudates if one or more of the following criteria are met.1. Pleural fluid protein/ serum protein ratio >0.052. Pleural fluid LDH / serum LDH ratio > 0.63. Pleural fluid LDH > two third of the upper limit or normal serum LDHCauses of Transudative Pleural Effusions1. Congestive heart failure2. Cirrhosis3. Pulmonary embolization4. Nephrotic syndrome* Peritoneal dialysis* SVC obstruction* Myxedema* UrinothoraxAMYLASE ELEVATEDGLUCOSE < 60mg/dl* Causes: Esophageal rupture* Pancreatic pleural effusion* Malignancy* Malignancy* Bacterial infection* Rheumatoid pleuritisCholesterol effusions:* Tuberculosis* Carcinoma* Nephrotic syndrome* Myxedema* Post myocardial infection
Category:
Medicine
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