WorksheetsPleural Fluid CML
Total questions: 25
Worksheet time: 13mins
milky white pleural fluid should be?
smelled
centriguged
cultured
tasted
Grossly purulent fluid signifies?
Empyema
Transudative exudate
Chlous Effusion
Hemopneumothorax
A persistently turbid supernatant suggests which effusion?
Empyema
Transudative
Chylous
Exudative
Chylous effusions typically caused by?
Communicating pneumothorax
Disruption of the thoracic duct
Small Cell Carcinoma
Cor Pulmonale
________ ocurs in the setting of normal capillary integrity and suggest absence of local pleural dz. 90% CHF
Transudates
Exudative
__________ form as a result of pleural dz associated / increased capillary permeability or reduced lymphatic drainage
Transudates
Exudates
Select the two most common causes of exudative effusion
Bacterial pneumonia
Cancer
Superior Vena Cava Syndrome
Emphyema
Cor Pulmonale
TB is a exudate or transudate?
Exudate
Transudate
Heart failure is an exudate or transudate?
Transudate
Exudate
When should pleural fluid specimens be sent for cytologic exam?
if pt is suspected of harboring a maligenecy
always, all pleural fluids have cytologic exam
never
if other pleural fluid tests come back abnormal
Pleural Fluid Analysis: Glucose
_______ has same concentration as serum?
Transudate
Exudate
Pleural Fluid Analysis: Glucose
<30 mg/dL we are concerned for what?
TB
Malignancy
Rheumatoid
SLE
Pleural Fluid Analysis: Glucose
30-50 mg/dL: what do we suspect if the glucose is in this range? (3)
TB
Malignancy
Rheumatoid
SLE
Transudative Exudate
Pleural Fluid Analysis: pH
pH less than 7.3 always indicates exudate or transudate or both?
exudate
transudate
can indicate either
Pleural Fluid Analysis: pH
<6.0 is consistent w?
GERD
Esophageal rupture
AAA
Cor Pormonale
Collagen vascular disease could be indicated at what pH?
<7.0
=7
>7
what RBC count would we need to have in pleural fluid for it to have red tinge?
100-200
500-600
1000-2000
5000-6000
RBC in pleural fluid of >100,000 would NOT indicate what?
Malignancy
Pulmonary Infarct
Trauma
Spontaneous Pneumothorax
WBC <1,000 indicates transudate or exudate?
Transudate
Exudate
Pleural Fluid Analysis: WBC
WBC > 50,000 indicates?
Parapneumonic effusion (usually empyema)
Transudative effusion
Cor Pulmonale
Malignancy
Pleural Fluid Analysis: WBC
in general, what WBC would indicate inflammation?
>100
>1000
>10000
>100,000
PF: venous hematocrit ratio > WHAT suggests trauma, bleeding from a vessel, bleeding disorder or malignancy
>1
>2
>3
>4
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?
Pleural Fluid LDH/ serum LDH >0.6
Pleural fluid protein/ serum protien >0.5
Pleural fluid LDH >2/3 upper limit of normal LDH
Pleural fluid pH / PH > 8.0
Pleural fluid RBC / RBC <1000
Wright stain differentiates...
PMNs from mononuclear cells
Lymphocytes from monocytes
PMNs dominate in early or late inflammatory effusions?
Eary
Late
Dominates in both
