The protein content is less than 30 g/L and the LDH is less than 200 IU/L.
hypoproteinaemia (e.g. nephrotic syndrome)
Ovarian tumours producing right-sided pleural effusion - Meigs' syndrome
The protein content of exudates is more than 30 g/L and the LDH is less than 200 IU/L.
bacterial pneumonia (common)
carcinoma of the bronchus and pulmonary infarction - fluid may be blood-stained (common)
post-myocardial infarction syndrome (rare)
acute pancreatitis (high amylase content) (rare)
sarcoidosis (very rare)
yellow-nail syndrome (effusion due to lymphoedema) (very rare
Light’s criteria for Exudate:
1-the ratio of pleural fluid to serum protein is >0.5
2-the ratio of pleural fluid to serum LDH is >0.6
3-the pleural fluid LDH is >⅔ of the upper limit for blood LDH level
Serum-effusion albumin gradient
Gradient <1.2 g/dl indicate exudate
Gradient >1.2 g/dl indicate transudate
Examin this patient chest.
proceed as follow:
stand at the edge of the bed.
observe if the patient is SOB,respiratory movements,scar,aspiration mark.
1-decrease movement in the left side
3-deminished breath sounds.
4-decrease vocal resonance
5-dont forget the trachea position
differential diagnosis of dullness.
how would you investigate this patient?
how would differentiate between exudate and transudate and what the common causes of each?
look for clues...!
clubbing,nicotine staining,lymphadenopathy,radiation marks,etc