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Hey! Happy 4th of July! šŸŽ† How can I help you today?

Gim me y Qs on Plural effusion for test

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Ask me Q's i'll answer

Got it! Let's do a quiz. I'll ask one question at a time, wait for your answer, then give feedback and move to the next.
Q1.
A 60-year-old man with known congestive heart failure presents with bilateral pleural effusions. Thoracentesis reveals:
  • Pleural fluid protein / Serum protein = 0.4
  • Pleural fluid LDH / Serum LDH = 0.5
  • Pleural fluid LDH = 150 U/L (upper limit of normal serum LDH = 300 U/L)
Based on Light's criteria, how would you classify this effusion ā€” transudate or exudate? And what is the rule?

Tramudale)l

āœ… Correct! It's a Transudate.
Here's why - none of the 3 Light's criteria are met:
  • Fluid protein/serum protein = 0.4 (< 0.5 āœ“)
  • Fluid LDH/serum LDH = 0.5 (< 0.6 āœ“)
  • Fluid LDH = 150, which is < 2/3 of 300 (i.e., < 200) āœ“
An effusion is an exudate if ANY ONE of the three criteria is met. Since none are met here ā†’ Transudate.
Common causes: CHF, cirrhosis, nephrotic syndrome, hypoalbuminemia.
Q2.
A patient with a parapneumonic pleural effusion has thoracentesis performed. The pleural fluid pH comes back at 7.1.
What does this indicate, and what is the immediate management?

Idk

No worries! Here's the answer:
Pleural fluid pH < 7.0 ā†’ Empyema or esophageal rupture ā†’ Tube thoracostomy (chest drain)
The pH rules to remember:
pHSignificanceAction
< 7.3Parapneumonic effusion, malignancy, TB, rheumatoid, systemic acidosisInvestigate further
< 7.0Empyema or esophageal ruptureTube thoracostomy
In this question, pH = 7.1 ā€” that's < 7.3 but > 7.0, so it strongly suggests a complicated parapneumonic effusion, and chest tube drainage is indicated.
A pH < 7.0 would make you think empyema or esophageal rupture specifically.
Q3.
A patient has a massive pleural effusion on CXR. You notice the trachea and mediastinum are shifted toward the side of the effusion.
What does ipsilateral mediastinal shift suggest in the context of pleural effusion?
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