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Pleural Fluid CML

Total questions: 25

Worksheet time: 13mins

Name
Class
Date
1.

milky white pleural fluid should be?

a)

smelled

b)

centriguged

c)

cultured

d)

tasted

2.

Grossly purulent fluid signifies?

a)

Empyema

b)

Transudative exudate

c)

Chlous Effusion

d)

Hemopneumothorax

3.

A persistently turbid supernatant suggests which effusion?

a)

Empyema

b)

Transudative

c)

Chylous

d)

Exudative

4.

Chylous effusions typically caused by?

a)

Communicating pneumothorax

b)

Disruption of the thoracic duct

c)

Small Cell Carcinoma

d)

Cor Pulmonale

5.

________ ocurs in the setting of normal capillary integrity and suggest absence of local pleural dz. 90% CHF

a)

Transudates

b)

Exudative

6.

__________ form as a result of pleural dz associated / increased capillary permeability or reduced lymphatic drainage

a)

Transudates

b)

Exudates

7.

Select the two most common causes of exudative effusion

a)

Bacterial pneumonia

b)

Cancer

c)

Superior Vena Cava Syndrome

d)

Emphyema

e)

Cor Pulmonale

8.

TB is a exudate or transudate?

a)

Exudate

b)

Transudate

9.

Heart failure is an exudate or transudate?

a)

Transudate

b)

Exudate

10.

When should pleural fluid specimens be sent for cytologic exam?

a)

if pt is suspected of harboring a maligenecy

b)

always, all pleural fluids have cytologic exam

c)

never

d)

if other pleural fluid tests come back abnormal

11.

Pleural Fluid Analysis: Glucose

_______ has same concentration as serum?

a)

Transudate

b)

Exudate

12.

Pleural Fluid Analysis: Glucose

<30 mg/dL we are concerned for what?

a)

TB

b)

Malignancy

c)

Rheumatoid

d)

SLE

13.

Pleural Fluid Analysis: Glucose

30-50 mg/dL: what do we suspect if the glucose is in this range? (3)

a)

TB

b)

Malignancy

c)

Rheumatoid

d)

SLE

e)

Transudative Exudate

14.

Pleural Fluid Analysis: pH

pH less than 7.3 always indicates exudate or transudate or both?

a)

exudate

b)

transudate

c)

can indicate either

15.

Pleural Fluid Analysis: pH

<6.0 is consistent w?

a)

GERD

b)

Esophageal rupture

c)

AAA

d)

Cor Pormonale

16.

Collagen vascular disease could be indicated at what pH?

a)

<7.0

b)

=7

c)

>7

17.

what RBC count would we need to have in pleural fluid for it to have red tinge?

a)

100-200

b)

500-600

c)

1000-2000

d)

5000-6000

18.

RBC in pleural fluid of >100,000 would NOT indicate what?

a)

Malignancy

b)

Pulmonary Infarct

c)

Trauma

d)

Spontaneous Pneumothorax

19.

WBC <1,000 indicates transudate or exudate?

a)

Transudate

b)

Exudate

20.

Pleural Fluid Analysis: WBC

WBC > 50,000 indicates?

a)

Parapneumonic effusion (usually empyema)

b)

Transudative effusion

c)

Cor Pulmonale

d)

Malignancy

21.

Pleural Fluid Analysis: WBC

in general, what WBC would indicate inflammation?

a)

>100

b)

>1000

c)

>10000

d)

>100,000

22.

PF: venous hematocrit ratio > WHAT suggests trauma, bleeding from a vessel, bleeding disorder or malignancy

a)

>1

b)

>2

c)

>3

d)

>4

23.

Light's Criteria dicates only 1/3 of these options need to be positive for us to consider pleural effusion an exudate. What are the 3 criteria?

a)

Pleural Fluid LDH/ serum LDH >0.6

b)

Pleural fluid protein/ serum protien >0.5

c)

Pleural fluid LDH >2/3 upper limit of normal LDH

d)

Pleural fluid pH / PH > 8.0

e)

Pleural fluid RBC / RBC <1000

24.

Wright stain differentiates...

a)

PMNs from mononuclear cells

b)

Lymphocytes from monocytes

25.

PMNs dominate in early or late inflammatory effusions?

a)

Eary

b)

Late

c)

Dominates in both