Flashcards in Clinical: Pleural Disease Deck (12):
Most sensitive layer when performing a pneumocentesis.
Layer of tissue that reabsorbs pleural fluid.
Function of pleural mesothelial cells
Maintain balance between coagulation and fibrinolysis
Where does the pleural fluid originate and where does it drain?
Diffuses into the pleural space from the bronchial and intercostal mircoarteries.
Drains into the bronchial and intercostal veins along with lymphatic vessels.
What two mechanisms cause an increase in pleural fluid?
Increased fluid entry due to starling force imbalance
Decreased fluid exit due to inflammation, obstruction (lymphomas), heart failure, or endocrine abnormalities
In which systemic conditions is pleural inflammation common?
Lupus, hypothyroidism, amyloid, yellow nail syndrome
What are the 3 major causes of pleural fluid transudate?
What is Light's Diagnostic Criteria for a fluid to be considered exudate?
1. Pleural fluid protein/serum ratio greater than 0.5
2. Fluid LDH/serum ratio greater than 0.6
3. Fluid LDH greater than 2/3 of the upper limit of lab normal for LDH
-if one of these is true=exudate
(LDH is lactate dehydrogenase)
What are the 3 most important components analyzed in pleural fluid chemical analysis?
What 3 conditions can increase fluid protein concentrations toward the exudate range?
3. TB infection
What conditions can increase serum LDH levels?
Empyema, rheumatoid pleurisy, pleural paragonimiasis (worm infection), malignancy