Pleural aspirate analysis

Question 1

Pleural fluid analysis;

What is clear, straw-coloured?

Answer 1

Transudate & exudate

Question 2

Pleural fluid analysis;

What is turbid yellow?

Answer 2

Empyema,

parapneumonic effusion (not infected but caused by finlam. of pleura due to pneumonia)

Question 3

Pleural fluid analysis;

What if theres blood/ red?

Answer 3

Truma, malignancy, pulmonary infarction

Question 4

Pleural fluid analysis;

What if theres inc. neutrophils in cytology?

Answer 4

Parapneumonic effusion, PE

Question 5

Pleural fluid analysis;

What if theres inc lymphocytes in cytology?

Answer 5

Malignancy, TB, RA, SLE, sarcoidosis

Question 6

Pleural fluid analysis;

What if theres mesothelial cells in cytology?

Answer 6

Pulmonary infarction

Question 7

Pleural fluid analysis;

What if theres abnormal mesothelial cells in cytology?

Answer 7

Mesothelioma

Question 8

Pleural fluid analysis;

What if theres multinucleated giant cells in cytology?

Answer 8

RA

Question 9

Pleural fluid analysis;

What if theres lupus erythematosus cells?

Answer 9

SLE

Question 10

Pleural fluid analysis;

What if protein

Answer 10

Transudate

Question 11

Pleural fluid analysis;

What if protein >35g/L?

Answer 11

Exudate

Question 12

Pleural fluid analysis;

What if protein 25-35g/L?

Answer 12

If fluid or serum protein >half its exudate.

Below 0.5 is transudate

Question 13

Pleural fluid analysis;

What if glucose or pH or inc LDH?

(Low glucose & pH, high LDH)

Answer 13

Empyema, malignancy, TB, RA, SLE

Question 14

Pleural fluid analysis;

What if amylase is raised?

Answer 14

Pancreatitis, carcinoma, bacteral pneumonia, oesophageal rupture

Question 15

Pleural fluid analysis;

What if theres rheumatoid factor?

Answer 15

RA

Question 16

Pleural fluid analysis;

What if theres antinuclear antibody?

Answer 16

SLE

Question 17

Pleural fluid analysis;

What if theres low complement levels?

Answer 17

RA, SLE, malignancy, infection