Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
A 55-year-old asthmatic woman, on systemic steroids for 1 year, has developed a recent right pleural effusion. She feels unwell and tires easily. Aspiration revealed a turbid fluid with numerous lymphocytes and a high lactate dehydrogenase (LDH) and low glucose level. Fluid pH is 7.4. The most likely diagnosis is
1) a pulmonary embolism.
2) an empyema.
3) tuberculosis.
4) a subphrenic abscess.
5) pancreatitis
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
empyema.........but ph doubtfull
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
empyema.........but ph doubtfull
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
TB .... for empyma we should have PH < 7.2
in addition the compelling fact of the lymphocytosis impose TB on us !!
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
why not Pancreatitis, pH=7.4
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
3) tuberculosis.
low glucose level in plural effusion goes wth
Empyme (ph is not low here in the q)
TB
cancer
Reumatic arthritis
note:
pancretitis does not cause low glucose level
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
3 tb because of steroid use and lympocytes
