General pathology Q

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General pathology Q

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jean robert
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12/12/07 - 12:10 PM

A chest radiograph of a 35 y.o. male demonstrates large, bilateral pleural effusions that have accumulated in the past 24 hours. Thoracocentesis is performed, and 500 ml of slighly cloudy yellow fluid is removed. Cytologic examination of fluid is removed. Cytologic examination of the fluid reveals many neutrophils but no lymphocytes or red blood cells. Which of the following mechanisms contributes to the accumulation of the fluid in the pleural space?

a.-Arteriolar vasoconstrition

b.-Neutrophil release of lysosomes

c.-Endothelial contraction

d.-Inhibition of platelet adherence

e.-Lymphatic obstruction

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hope4dabest
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12/12/07 - 12:35 PM

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12/13/07 - 11:42 AM

new_n_lost
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12/13/07 - 12:44 PM

c.-Endothelial contraction

Histamine released by Leucocytes causes the contraction of mainly venules and thus creating the endothelial gaps for the protein rich fluid in the interstitium resulting in an exudate, while the net flow of the fluid surpasses the lymphatic capability the fliud then accumulates in the body cavity ( pleural space). Hence the effusion, its not lymphatic obstruction that leads to the pleural effusion buit the overflow of the lymphatics that cause the effusion.

My 2 cents.

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hope4dabest
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12/13/07 - 09:52 PM

http://www.emedicine.com/emerg/topic462.htm

Its pathogenesis gives one of the causes of pleural effusion as lymphatic obstruction....Is there something else in the qusetion which i am not getting????

new_n_lost
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12/13/07 - 10:21 PM

Well i gave my answer based on 1 point

Goljan RR 2nd ed.pg 77 Point 2 Inc Vascular permeabiltiy. Then straight jump to pg 22 C Sequential Events points 1-5. Then come to Pg 325 Lists both lymphatic obstruction and infection or inflammation as both causes. I choose C based on point in the question that there was a cloudy yellow appearance and presence of neutrophils whilst no other cells. I took it as inflammation.

@ HOPE
Also go through this section of the same article.

I have given my 2 cents not very very confident on the answer.

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"never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."

deja_vu

12/13/07 - 11:14 PM

new_n_lost wrote:
c.-Endothelial contraction

Histamine released by Leucocytes causes the contraction of mainly venules and thus creating the endothelial gaps for the protein rich fluid in the interstitium resulting in an exudate, while the net flow of the fluid surpasses the lymphatic capability the fliud then accumulates in the body cavity ( pleural space). Hence the effusion, its not lymphatic obstruction that leads to the pleural effusion buit the overflow of the lymphatics that cause the effusion.

My 2 cents.

jean robert
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12/21/07 - 09:33 PM

Correct answer: C

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GoodGirl
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12/21/07 - 09:48 PM

Thanks NNL for the explanation.

Now I know I must be more careful reading Goljan RR !

Good question, Jean. Still do you have some explanation along with it?

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acintya
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12/21/07 - 09:58 PM

#10

That's the same message for me too GG: need to learn well from RR! phew.... rolling eyes

Thanks NNL and Jean!

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