1.1.2014 Flashcards
Normal pleural fluid chemistries
pH 7.60
LDH <0.5 of serum
glucose 0.6-0.8 of serum
Lights criteria
fluid:serum protein ratio <0.67 of ULN of serum
pseudo exudate
diuretic treated CHF,Cirrhosis,nephrotic syndrome
test to identify pseudo exudate
serum to pleural fluid albumin gradient> 1.2
Hct of pleural fluid in hemothorax
> 0.5 of serum
volume of pleural fluid and chest x ray
obscure posterior costophrenic sulcus: 75ml
obscure lateral costophrenic sulcus: 175ml
entire diaphragmatic contour is obscured: 500 ml
fluid reaches the anterior 4th rib: 1000 ml
bloody pleural fluid is seen in
trauma
malignancy
pulmonary embolism
lymphocytosis in pleural fluid
>85% tuberculous lymphoma sarcoid pseudoexudate chronic rheumatoid
eosinophilia in pleural fluid
pneumothorax hemothorax fungal parasitic drugs malignancy benign asbestos effusion
pleural fluid protein levels and conditions
> 3g/dl most exudates
4 tuberculous
7-8 blood cell dyscrasias
pleural fluid LDH>1000U/L
empyema
high burden malignancy
rheumatoid
paragonimiasis
fluid:serum LDH ratio >1
pneumocystis
urinothorax
TGL level in chylothorax?
> 110 mg/dl
how much of fluid can be safely removed by large volume paracentesis
1.5L
massive hemoptysis
more than 600ml of blood in 24 hrs
difference btw primary cilliary dyskinesia and cystic fibrosis
normal sweat chloride
limited GI symptoms
swachmann diamond syndrome
pancreatic insufficiency
cyclic neutropenia
short stature
CF commonly affects which lung lobe
upper
Longterm adverse effects of inhaled aerosolized tobramycin
voice change
tinnitus
empirical antibiotic therapy for acute exacerbations in cystic fibrosis
IV semisynthetic penicillin+ 3 or 4 G cephalosporins or FQs+aminoglycosides
Diabetic pts with no dietary restriction
cystic fibrosis
strong predictor of mortality in CF pts
FEV1
