PAEA Surgery End Of Rotation (EOR) Practice Exam

What are physical signs of pleural effusion?

1. Increased tactile fremitus

2. Asymmetrical chest expansion

3. Hyperresonance on percussion

4. Severe cough

The correct answer is: Asymmetrical chest expansion

Asymmetrical chest expansion is a key physical sign of pleural effusion. When fluid accumulates in the pleural space, it can cause the affected lung to collapse partially or fully, leading to a decrease in lung volume on that side. This results in limited expansion of the chest wall on the side where the effusion occurs. When a healthcare provider examines a patient, they will note that when the patient takes a deep breath, one side of the chest rises less than the other. This asymmetry in chest movement serves as an important clinical indicator of the presence of fluid in the pleural cavity. In contrast, increased tactile fremitus is typically seen in conditions such as lobar pneumonia, where lung consolidation enhances the transmission of vibrations through lung tissue. Hyperresonance on percussion suggests conditions like pneumothorax rather than pleural effusion, which typically presents with dullness due to fluid. Severe cough is not specific to pleural effusion and can occur with many different respiratory conditions. Understanding these nuances helps in accurately recognizing signs associated with pleural effusion and differentiating them from other respiratory conditions.