USMLE Forum Archives - USMLE Step 2 CK - int.med.
int.med.
ysemak - 01-13-10 11:50
A 65y/o woman is found to have a left-sided pleural effusion on chest x-ray. Analysis of the pleural fluid reveals a ratio of concentration of total protein in pleural fluid to serum of 0.38, a lactate dehydrogenase (LDH) level of 125 IU, and a ratio of LDH concentration in pleural fluid to serum of 0.46. Which of the following disorders is most likely in this patient?
ysemak - 01-13-10 11:50
A 65y/o woman is found to have a left-sided pleural effusion on chest x-ray. Analysis of the pleural fluid reveals a ratio of concentration of total protein in pleural fluid to serum of 0.38, a lactate dehydrogenase (LDH) level of 125 IU, and a ratio of LDH concentration in pleural fluid to serum of 0.46. Which of the following disorders is most likely in this patient?
The correct answer and explanation will be available after you answer.
Page 1
#1
Re: int.med. conym5 - 01-13-10 12:21 My answer is: b.
total protein in pleural fluid to serum of 0.38, a lactate dehydrogenase (LDH) level of 125 IU, and a ratio of LDH concentration in pleural fluid to serum of 0.46 are clues for transudate, so go with CHF
#2
Re: int.med. oldman - 01-14-10 12:23 My answer is: b.
that is transudat, other choices represents exudate
#6
Re: int.med. conym5 - 01-17-10 08:25 Sarcoidosis , SLE , rheumatoid arthritis and other autoimmune, connective tissue disorders and pulmonary embolism can cause exudate , but CHF causes only transudate...
#7
Re: int.med. mtniharika - 01-17-10 08:58 My answer is: b.
criteria proposed by Light for an exudative effusion are met if at least one of the following exists (Light's criteria):
The ratio of pleural fluid protein to serum protein is greater than 0.5
The ratio of pleural fluid LDH and serum LDH is greater than 0.6
Pleural fluid LDH is more than two-thirds normal upper limit for serum
here itseems to be a transudate.
#14
Re: int.med. ammulufy - 03-21-10 19:12 My answer is: c.
The ratio indicates transudate cause of pleural effusion n out of all the options CHF fits the bill......but CHF manifests in the form of bilateral rales n not unilaterally.......I feel pul.embolism is d probable answer
#15
Re: int.med. ammulufy - 03-21-10 19:14 I didnt know dat pul.embolism is one of the exudative causes of pleural effusion.....
#19
Re: int.med. babbu5508 - 05-23-10 03:23 My answer is: b.
Transudate Pleural Effusion causes:
Congestive Heart Failure
cirrhosis
Pneumonia
Nephrotic Syndrome or hypoalbuminemia
Pulmonary Atelectasis
Peritoneal dialysis
Constrictive Pericarditis
Obstruction of superior vena cava
Page 1