- 1 On being a patient
- 2 Modern medicine: foundations, achievements, and limitations
- 3 Global patterns of disease and medical practice
- 4 Cell biology
- 5 Immunological mechanisms
- 6 Principles of clinical oncology
- 7 Infection
- 8 Sexually transmitted diseases and sexual health
- 9 Chemical and physical injuries and environmental factors and disease
- 10 Clinical pharmacology
- 11 Nutrition
- 12 Metabolic disorders
- 13 Endocrine disorders
- 14 Medical disorders in pregnancy
- 15 Gastroenterological disorders
- 16 Cardiovascular disorders
- 17 Critical care medicine
- 18 Respiratory disorders
- 18.1 Structure and function
- 18.2 The clinical presentation of respiratory disease
- 18.3 Clinical investigation of respiratory disorders
- 18.4 Respiratory infection
- 18.5 The upper respiratory tract
- 18.6 Allergic rhinitis
- 18.7 Asthma
- 18.8 Chronic obstructive pulmonary disease
- 18.9 Bronchiectasis
- 18.10 Cystic fibrosis
- 18.11 Diffuse parenchymal lung diseases
- 18.12 Sarcoidosis
- 18.13 Pneumoconioses
- 18.14 Miscellaneous conditions
- 18.15 Chronic respiratory failure
- 18.16 Lung transplantation
- 18.17 Pleural diseases
- 18.18 Disorders of the thoracic cage and diaphragm
- 18.19 Malignant diseases
- 19 Rheumatological disorders
- 20 Disorders of the skeleton
- 21 Disorders of the kidney and urinary tract
- 22 Disorders of the blood
- 23 Disorders of the skin
- 24 Neurological disorders
- 25 The eye
- 26 Psychiatry and drug related problems
- 27 Forensic medicine
- 28 Sports medicine
- 29 Geratology
- 30 Pain
- 31 Palliative medicine
- 32 Biochemistry in medicine
- 33 Acute medicine
(p. 3486) Pleural diseases
- Chapter:
- (p. 3486) Pleural diseases
- Author(s):
Robert J.O. Davies
, Fergus V. Gleeson
, Y.C. Gary Lee
, Jose Porcel
, and Fraser Brims
- DOI:
- 10.1093/med/9780199204854.003.1817_update_001
Update:
Investigation—enhanced discussion of distinction between transudative and exudative effusions, use of measurement of ADA activity in diagnosis of tuberculosis, and tumour biomarkers.
Specific causes of effusion and pleural diseases—expanded notes on rheumatoid arthritis, SLE, benign asbestos pleural effusion, benign asbestos-related pleural plaques, and rounded atelectasis.
Pneumothorax—comments on use of diagnostic ultrasound, the role of suction for continuing air leak, the timing of surgery, and use of endobronchial valves.
A relevant case history from Oxford Case Histories in Respiratory Medicine has been added to this chapter.
Case History—A 40 yr old woman with pleuritic chest pain.
This is a common clinical problem which can complicate a range of lung and systemic diseases. Most cases can be diagnosed by pleural fluid analysis and pleural biopsy, with Light’s criteria making it possible to discriminate between transudates and exudates. These state that a pleural effusion is an exudate if any of the following are present: (1) pleural fluid to serum protein ratio greater than 0.5; (2) pleural fluid lactate dehydrogenase (LDH) greater than two-thirds of the upper limit of normal serum LDH; (3) pleural fluid to serum LDH ratio greater than 0.6....
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- 1 On being a patient
- 2 Modern medicine: foundations, achievements, and limitations
- 3 Global patterns of disease and medical practice
- 4 Cell biology
- 5 Immunological mechanisms
- 6 Principles of clinical oncology
- 7 Infection
- 8 Sexually transmitted diseases and sexual health
- 9 Chemical and physical injuries and environmental factors and disease
- 10 Clinical pharmacology
- 11 Nutrition
- 12 Metabolic disorders
- 13 Endocrine disorders
- 14 Medical disorders in pregnancy
- 15 Gastroenterological disorders
- 16 Cardiovascular disorders
- 17 Critical care medicine
- 18 Respiratory disorders
- 18.1 Structure and function
- 18.2 The clinical presentation of respiratory disease
- 18.3 Clinical investigation of respiratory disorders
- 18.4 Respiratory infection
- 18.5 The upper respiratory tract
- 18.6 Allergic rhinitis
- 18.7 Asthma
- 18.8 Chronic obstructive pulmonary disease
- 18.9 Bronchiectasis
- 18.10 Cystic fibrosis
- 18.11 Diffuse parenchymal lung diseases
- 18.12 Sarcoidosis
- 18.13 Pneumoconioses
- 18.14 Miscellaneous conditions
- 18.15 Chronic respiratory failure
- 18.16 Lung transplantation
- 18.17 Pleural diseases
- 18.18 Disorders of the thoracic cage and diaphragm
- 18.19 Malignant diseases
- 19 Rheumatological disorders
- 20 Disorders of the skeleton
- 21 Disorders of the kidney and urinary tract
- 22 Disorders of the blood
- 23 Disorders of the skin
- 24 Neurological disorders
- 25 The eye
- 26 Psychiatry and drug related problems
- 27 Forensic medicine
- 28 Sports medicine
- 29 Geratology
- 30 Pain
- 31 Palliative medicine
- 32 Biochemistry in medicine
- 33 Acute medicine