Pleural and Peritoneal Fluid Analysis Flashcards

1
Q

what different fluids could accumulate within the pleural cavity?

A
  • pleural fluid (pleural effusion)
  • blood (haemothorax)
  • lymph (chylothorax)
  • pus (empyema)
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2
Q

what kind of pleural effusion is more likely to be exudative?

A

a unilateral one

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3
Q

in which condition is pH of pleural fluid in an effusion low?

A

empyema

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4
Q

common causes of a transudative pleural effusion?

A

all the failures:

  • heart failure
  • liver failure
  • nephrotic syndrome (“renal failure”)
  • hypoalbuminaemia (“nutritonal failure”)
  • hypothyroidism (“thyroid failure”)
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5
Q

common causes of exudative pleural effusion?

A
  • cancer
  • pneumonia
  • PE / infarction
  • TB
  • RA and other conn tissue diseases
  • acute pancreatitis
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6
Q

what is the normal colour of pleural fluid?

A

straw-coloured

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7
Q

differential for yellow pleural fluid?

A

infection

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8
Q

differentials for blood-stained pleural fluid?

A
  • trauma

- cancer

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9
Q

differential for frank blood in pleural fluid?

A
  • mesothelioma

- trauma

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10
Q

differential for pus in pleural fluid?

A

empyema

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11
Q

differential for food debris in pleural fluid?

A

oesophageal rupture

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12
Q

commonest cause of ascites?

A

portal HTN secondary to liver cirrhosis

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13
Q

when is ascites exudative?

A

when protein levels are >25 g/L

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14
Q

when is a pleural effusion exudative?

A

when protein levels are >30 g/L

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15
Q

what is SAAG? how is it worked out?

A
  • serum-ascites albumin gradient

- literally subtracting ascites albumin level from serum level

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16
Q

what SAAG score is significant? what does this indicate?

A

> 11 g/L means the pt is very likely to have portal HTN (but could still have another transudative cause)

17
Q

how is SBP diagnosed in a pt with ascites?

A
  • when the WCC is >250 cells / mm cubed

- alternatively, when the sample is cultured and found to have bacteria

18
Q

chest findings in RA?

A
  • pleural effusion (exudative)
  • pulmonary nodules
  • interstitial fibrosis
  • pleural thickening
  • bronchiolitis obliterans
19
Q

typical causative organisms in SBP?

A
  • E. coli

- klebsiella