Pleural and Peritoneal Fluid Analysis Flashcards
what different fluids could accumulate within the pleural cavity?
- pleural fluid (pleural effusion)
- blood (haemothorax)
- lymph (chylothorax)
- pus (empyema)
what kind of pleural effusion is more likely to be exudative?
a unilateral one
in which condition is pH of pleural fluid in an effusion low?
empyema
common causes of a transudative pleural effusion?
all the failures:
- heart failure
- liver failure
- nephrotic syndrome (“renal failure”)
- hypoalbuminaemia (“nutritonal failure”)
- hypothyroidism (“thyroid failure”)
common causes of exudative pleural effusion?
- cancer
- pneumonia
- PE / infarction
- TB
- RA and other conn tissue diseases
- acute pancreatitis
what is the normal colour of pleural fluid?
straw-coloured
differential for yellow pleural fluid?
infection
differentials for blood-stained pleural fluid?
- trauma
- cancer
differential for frank blood in pleural fluid?
- mesothelioma
- trauma
differential for pus in pleural fluid?
empyema
differential for food debris in pleural fluid?
oesophageal rupture
commonest cause of ascites?
portal HTN secondary to liver cirrhosis
when is ascites exudative?
when protein levels are >25 g/L
when is a pleural effusion exudative?
when protein levels are >30 g/L
what is SAAG? how is it worked out?
- serum-ascites albumin gradient
- literally subtracting ascites albumin level from serum level
what SAAG score is significant? what does this indicate?
> 11 g/L means the pt is very likely to have portal HTN (but could still have another transudative cause)
how is SBP diagnosed in a pt with ascites?
- when the WCC is >250 cells / mm cubed
- alternatively, when the sample is cultured and found to have bacteria
chest findings in RA?
- pleural effusion (exudative)
- pulmonary nodules
- interstitial fibrosis
- pleural thickening
- bronchiolitis obliterans
typical causative organisms in SBP?
- E. coli
- klebsiella
