Lecture 18 - pleural disease cases (specht) Flashcards
thoracocentesis is preformed ventral thorax and __ to the rib
cranial!
a/v/n run caudal, don’t hit these
Thoracocentesis cytology yeilds 1.5g/dL TP and 80 WBC/mcL with predominant macs and some lymphos
transudate - most likely resulted from increased hydrostatic pressure!
what changes in starling’s forces result in a transudate
increased hydrostatic pressure decreased oncotic pressure permeability changes (vasculitis, inflammation, pancreatitis)
ddx for a pure transudate include
hypoalbuminemia
neoplasia
CHF
FIP would be modified trans to exudate
cat with RHF vs LHF effusion classification
RHF - modified transudate bc sinusoid liver vessels
LHF = pure transudate
TP 5.8, WBC 200k/ul, neutrophils predom, no bacteria observed
exudate; if cells are in 100ks then always an exudate!
ddx for exudate
neoplasia
FIP
bacterial infeciton
if suspect FIP what are some dx can perform
rivalta (positive) cornoavirus titer (positive) serum globulin (very high)
evidence for pyothorax
high fluid albumin:globulin ratio, clinical response to ab, high globulin
pink opaque effusion with white chunks settled at the bottom
exudate; chunks (sulfur granules) are suggestive of a nocardia or actinomyces infection
pull out a white, pink tinged effusion from the chest, what comparison would be most helpful
effusion:serum triglyceride (chyle has TG higher than serum)
what is the predom cell type in chylothorax
small lymphocytes
what changes can you see in a chronic chylothorax
if chronic chylothorax and not eating then will be macs/neuts and look more like a modified transudate
describes the protein and cell count in a chylous effusion
TP 2.5-5 (moderate)
WBC 500-2k (variable)
prognosis for chylothorax
medical management - very guarded
surgical - 50/50 (best option atm)
