Flashcards in Pleural Effusion Deck (13):
For fluid to be labeled exudate must meet one of these criteria:
1. Pleural Protein/serum protein >.5
2. Pleural LDH/serum LDH >.6
3. Pleural LDH >2/3 normal serum LDH
Pleural fluid characteristics that suggests need for chest tube drainage?
1. Empyema (pus in plural space)
2. Positive Gram stain
4. PH 1000
Amount of fluid needed in order to be visible on the lateral decubitus film? Amount of fluid needed to obscure entire hemidiaphragm on x-ray?
50 mL; 500 mL
Clear yellow pleural fluid suggests?
Chylothorax triglycerides >110 resulting from disruption thoracic duct or Cholesterol effusions
Bloody pleural fluid strata?
50% hemothorax secondary to trauma, malignancy, PE
How much fluid can be safely removed in a therapeutic thoracentesis? Risk if more than this amount is removed?
1500 mL; reexpansion pulmonary edema
Causes of transudative pleural effusions and radiographic features?
1. CHF – bilateral/symmetric or right-sided effusion
2. Nephrotic syndrome – bilateral and subpulmonic effusions
3. Cirrhosis – patients also have ascites
4. Malignancy – obstructed lymphatics
Signs of pleural effusion due to tuberculosis?
Adenosine deaminase >43
Protein > 4
< 10% acid-fast bacilli
If chest tube is initially placed it is kept until?
Drainage rate has decreased to < 50 mL per day
Treatment of multiloculated empyema?
Fibrinolytic agents (streptokinase or urokinase) through the chest tube
Exudative pleural effusions: signs of connective tissue disease?
Pleural effusion with Amylase suggests?
Pancreatitis or esophageal rupture