pleural space disease SDL

Question 1

Describe a pure exudate

Answer 1

clear in colour
protein <25g/l
low cellularity

Question 2

Describe a modified transudate

Answer 2

slightly hazy in colour
protein 25-40g/l
moderate cellularity

Question 3

describe a exudate

Answer 3

typically opaque in colour
protein >30g/l
moderate to high cell count

Question 4

describe a pyothorax

Answer 4

amber red or yellow in colour
protein >35g/l
high cell count and smells

Question 5

describe a chylothorax

Answer 5

creamy +/- pale pink in colour
protein variable
high cell count

Question 6

what are the characteristics of pleural space disease

Answer 6

muffled heart and lung sounds
characteristic respiratory pattern
inspiratory and expiratory effort

Question 7

How would you confirm a chylothorax

Answer 7

fluid serum triglyceride ratio check
–> the effusion fluid would be higher in triglycerides than the serum in the case of a chylothorax

Question 8

Describe how you would manage a patient with a chylothorax

Answer 8

place chest drains
give antibiotics and NSAIDS
remove chest drains when volume of fluid decreases
place on a low fat diet and rutin

can do contrast studies to look at the thoracic duct - may require surgical ligation