Resp - Lab Eval Of Pleural Effusion

Front 1

how can sputum be collected

Back 1

spontaneous expectoration
sputum induction

Front 2

when is tehe best sputum taken

Back 2

in the morning
5-10 mL

Front 3

contents of sputum

Back 3

<10 epis
10-25 epis
>25 leukocytes/LPF

Front 4

typical special media ordered

Back 4

mycobacteria
legionella
AFB
fungi

Front 5

characteristics of nL sputum

Back 5

ph =7.6
Pr = 1-2 g/dL
glucose ~plasma
LD<50% of plasma level
WBC <1000/uL

Front 6

what might cause the excess pleural efusion

Back 6

-excess fluid formation
-dec removal by lymphatics

Front 7

sources of fluid in pleural space

Back 7

-capilaries in parietal space
-drainage of interstitial spacs of the lung into the visceral pleura
-fluid from peritoneal cavity via small holes in diaphragm

Front 8

systemic factors of transudate

Back 8

-increased hydrostatic pressure
or
-decreased oncotic pressure

Front 9

ultrafiltrates of plasma in transudate contain

Back 9

-low MW substances
-low conc of high MW

Front 10

transudates are seen in what conditions

Back 10

-CHF
-cirrhosis with ascites
-nephrotic syndrome

Front 11

exudate:
local factors influencing the formation

Back 11

-increased capillary permeability or decreased lymphatic resorption
-release of inflammatory mediators involved
-increased concentration of high molecular weight proteins

Front 12

exudates may be seen in what conditions

Back 12

-pneumonia
-neoplasm
-infection

-asbestosis
-pancreatic dz
-chronic atelectasis

Front 13

two most useful criteria to identify T vs E

Back 13

-lactate dehydrogenase LDH
-total protein concentration

Front 14

exudate is defined by:

Back 14

one of the three:
1) pleural fluid Pr/serum Pr >0.5
2) pleural fluid LDh/serum LDH >0.6
3) pleural fluid LDH >2/3 nL upper limit for serum

Front 15

gross appearance:
cloudy, purulent
condition?

Back 15

infection

Front 16

gross appearance:
red tinged, bloody
condition?

Back 16

trauma
malignancy
pulmonary infarct

Front 17

gross appearance:
green-white, turbid
condition?

Back 17

RA

Front 18

gross appearance:
milky
condition?

Back 18

pseudochyloud or chylous

Front 19

exudative pleural fluid protein test:
glucose
conditions?

Back 19

less than 60mg/dL in RA, malignancy, purulent effusion

Front 20

exudative pleural fluid protein test:
amylase
conditions?

Back 20

elevated in esophageal rupture, pancreatic pleural effusion, malignancy

Front 21

exudative pleural fluid protein test:
triglycerides
conditions?

Back 21

positive in chylothorax

Front 22

abnL cell counts:
inc neutros
condition?

Back 22

bacterial infection (empyema)

Front 23

abnL cell counts:
inc lymphocytes
condition?

Back 23

-TB
-malignancy
-viral infections

Front 24

abnL cell counts:
inc eosins
condition?

Back 24

-pneumothorax
-empyema
-parastitic infections
-malignancies
-idiopathic effusions