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What is True about pleural effusion: March 2011 and explain in detail?
Ans. A: Amylase content is usually high in pancreatic effusion Pleural effusion in acute pancreatitis: Serous/ blood stained, exudate, no predominant cells and high amylase in pleural fluid (greater than in serum) Pleural effusion: Blood stained: - Pulmonary infarction, - Metastatic carcinoma, - TB Low glucose: - Rheumatoid ahritis/ RA, - Empyema Raised amylase: - Esophageal perforation, - Pancreatitis Cholesterol: Hypothyroidism, - TB, - RA Left sided effusion: - Pancreatitis, - Esophageal rupture Transudate: - Protein less than 3 gm/ 100 ml, - LDH less than 200 IU, LDH ratio less than 0.6, - Pleural fluid/ serum protein is less than 0.5 - pH less than 7.2: Empyema Chronic bronchitis/ blue bloaters: Clinical presence of productive cough not attributable to other causes on most days for at least 3 months over consecutive 2 years Reids index is used