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Old 05-28-2011
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Lungs Pleural Fluid Findings Question!

A 61 year old man is hospitalized. On the fifth day of his hospital stay, a chest x-ray film was obtained and showed a right sided pleural effusion. Thoracocentesis is performed yielding 25cc of fluid with a pleural fluid protein/serum protein ratio of 0.7 and a lactate dehydrogenase of 240 U/L. Which of the following conditions may lead to this finding within the pleural cavity?
A. Bacterial pleuritis.
B. Cirrhosis of the liver.
C. Congestive heart failure.
D. Nephrotic syndrome.
E. Protein losing enteropathy.

Please explain the answers..

Last edited by struggle; 05-28-2011 at 12:42 PM. Reason: mistake during typing
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Old 05-28-2011
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I think the answer is a)

Using the Light's criteria, this is an exudate...

options B,C,D & E (or in this case B,C,C & D ) are Transudate
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Old 05-28-2011
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haha..i corrected the typo mistake.
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Old 05-28-2011
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yes you are absolutely right..
According to lights criteria..
1.pleural fluid protein to serum protein ratio >0.5
2.pleural fluid LDH to serum LDH>0.6
3.pleural LDH >200 (or greater than 2/3 of the upper limit of LDH)
is exudate.

NOTE: when it is unilateral always consider a bacterial pleural effusion.
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Old 05-28-2011
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Why is the LDH level up? Is it from bacterial glucose metabolism?
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Old 05-28-2011
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LDH is a marker of tissue breakdown..so i thinks it is raised due to tissue destruction secondary to any disease like cancers,MI,Red blood cell destruction.So,it can rise secondary to inflammation
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Old 05-28-2011
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Quote:
Originally Posted by struggle View Post
LDH is a marker of tissue breakdown..so i thinks it is raised due to tissue destruction secondary to any disease like cancers,MI,Red blood cell destruction.So,it can rise secondary to inflammation
Oh right! Sorry didn't recognize it lol. Fail.
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