Investigation

Question 1

Relevant findings seen to findout the cause of pf

Answer 1

Oedema: Due to hypoalbuminaemia, nephrotic syndrome.
• Emaciation: Due to TB, malignancy.
• Malnutrition: May cause hypoalbuminaemia.
• Clubbing, nicotine stain, radiation mark: Due to bronchial carcinoma.
• Signs of CCF

Question 2

Investigations which should be done

Answer 2

Chest X-ray PA view (if small effusion, lateral decubitus view).
2. CBC with ESR (high ESR in TB, leucocytosis in pneumonia).
3. Mantoux test (MT).
4. Aspiration of fluid for analysis:
• Physical appearance (straw coloured, serous, haemorrhagic, chylous).
• Gram staining, cytology
• Biochemistry (protein and sugar).
• C/S.
• AFB
ANA, anti-ds DNA (in SLE).
• Liver function tests (in CLD).
• Urine for protein and serum total protein, Albumin:globulin ratio (in nephrotic syndrome).
• If palpable lymph node: FNAC or biopsy