M********r
发帖数: 179 | 1 这道题我可以选出正确答案，但是有些地方还是有点含糊。比如pleural fluid正常的
cell number 是多少，正常
protein 含量是多少？为何此患者胸腔积液细胞含量如此高？
A 70 year old man comes to the emergency department because of shortness of
breath for 2 hours. He had
a myocardial infarction 2 years ago. A chest X-ray shows bilateral Kerley B
lines and bilateral pleural
effusions that are great on the right. If a thoracentesis were done,
laboratory studies would show
serum total protein 7g/dl
pleural fluid
specific gravity 1.008
total protein 1g/dl
leukocyte count 500/mm3
pleural fluid plasma lactate dehydrogenase ratio 0.2
which of the following processes best explains the pleural fluid findings?
a. decreased vascular hydrostatic pressure
b. decreased vascular oncotic pressure
c. decreased vascular permeability
d. increased vascular hydrostatic pressure
e. increased vascular oncotic pressure
f. increased vascular permeability
gravity of pleural fluid is low, indicating
it's transudate. Three reasons,
consider serum total protein is normal,and the clinical manifesitation-probably a post-mi cardiac failure.
choice d is the right answer.
But my questions are:
specific gravity 1.008 suggests it's a transudate, but leukocyte count 500/
mm3 give you the info of
exudate. What it really is? if it's transudate, why it also has so many
leukocyte count? Is it because MI
reattack->more cortisol and NE secretion-> neutrophils that used to stuck to
the vessels now circulating?
But it's in pleural cavity...
Anyone has a better explanation? | M********r
发帖数: 179 | 2 有人知道吗？昨天看fa 觉得又开始糊涂了。
fa262（2010）, capillary fluid exchange: #. increased capillary permeability
(increased Kf: toxins,infections, burns)
如此说来，选项f 也应该是对的吧。 |
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