A 65-year-old man, heavy smoker with no other medical illness, has progressive shortness of breath over the last 2 months associated with loss of appetite and weight loss. He has no cough, fever, or chest pain. His HR is 88/min, BP 100/75 mmHg, RR 24/min, Spo2 91% on room air. His chest X-ray reveals massive right sided pleural effusion. Lung cancer is your working diagnosis Which of the following pleural fluid analysis results support the working diagnosis?
سؤال مجاني 5 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: B. Pleural fluid pH7.3, pleural protein/serum protein 0.7, pleural fluid LDH 500
Malignant effusions are exudates. By Light's criteria an exudate has pleural/serum protein >0.5 (or LDH ratio >0.6, or high pleural LDH). Option B (protein ratio 0.7, pleural LDH 500) is the only exudate. Options A, C and D all have protein ratio <=0.5 and low LDH ratios, i.e. transudates.
ليش كل خيار صح أو غلط
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A
ليش غلط
A pleural/serum protein ratio of 0.2 misses the exudate cut-off (above 0.5), and no LDH result is given that would make it an exudate.
✓ Plerual effusions.pdf · p. 6 -
B
ليش صح
Malignant pleural effusion is an exudate (exudative fluid with malignant cells), and B is the only option with an exudative result (protein ratio 0.7, pleural LDH 500).
✓ Pleural effusion.pdf · p. 7 -
C
ليش غلط
Protein ratio 0.4 and LDH ratio 0.3 are both below the exudate cut-offs (0.5 and 0.6), so this is a transudate.
✓ Plerual effusions.pdf · p. 6 -
D
ليش غلط
Protein ratio 0.4 and LDH ratio 0.5 are both below the exudate cut-offs (0.5 and 0.6), so this is a transudate.
✓ Plerual effusions.pdf · p. 6
- المصدر
- Plerual effusions.pdf · p. 6
Pleural effusion.pdf · p. 7 - المحاضرة
- Pleural Effusion & Pneumothorax · Pulmonology · Module B
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