Ivonne
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A 33 y.o male was involved in a motor accident with numerous rib fractures. His course in the hospital was complicated by difficulty with deep breathing and later developed pneumonia. CXR: parapneumonic effusion. Which one of the following lab tests on the pleural fluid is currently thought to be most helpful in determining the need for chest tube placement in parapneumonic effusion?.
A. LDH
B. WBC count
C. Pleural fluid pH
D. Total protein
E. Color of the pleural fluid
Please explain your answer
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| virgola82
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I think C because pH should be more specific than the other options for empyema, but am not sure
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| tanmaynator
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c.. pleural fluid ph less than 7.20.. gotta put in a chest tube.. also pleural fluid glucose.. these two i suppose..
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| MAGY17
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l go for LDH
WHY? because you need to do the ratios of effusion to serum (LDH AND PROTEIN FLUID) VS (LDH AND PROTEIN SERUN) the choice tha are posible are LDH or protein, NOT protein because choice say TOTAL PROTEIN.
OR NOT?
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| sprint123
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 --pH < 7.2---> Indication for chest tube drainage..
Total protein in pleural fluid and LDH in pleural fluid is determined to classify transudate or exudate!
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| Justice
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pH
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| dr in trouble
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Acc to UW it shud b PH
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| Ivonne
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Yep.
pH< 7.2 or glucose<60mg/dl indication for tube thoracostomy. If not parapneumonic effusions tend to loculate and form adhesions if not drained immediately with a chest tube.
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| MAGY17
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sprint123 thanks for your correction, you are righ.
THE ANS. IS PH
PH>7.2= only antibiotic
PH 7-7.2 may need repead thoracentesis
PH<7 tube thoracostomy
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