A 51 Year old man with a history of tuberculosis is found to have a unilateral pleural effusion

A pleural fluid

Question

A 51 Year old man with a history of tuberculosis is found to have a unilateral pleural effusion. A pleural fluid

specimen is obtained by thoracentesis and sent to laboratory for evaluation.

Blood Chemistry Resus: Reference Interval

Total Protein-7.0 g/dL6.0-8.3 mg/dLLD activity-520 U/L275-645 U/LGlucose, fasting- 75 mg/dL 111 mg/dL

Pleural Fluid Resus:

Physical ExaminationMicroscopic ExaminationChemical ExaminationColor: YellowLeucocytes: 1100 Cells/uLProtein: 4.2g/dLClarity: CloudyMononuclear Cells: 93%LD activity: 345 U/LClots Present: NoNeutrophils: 3%Glucose : 55mg/dL Gram Stain: No organisms seen Leukocytes Present

Calculate the fluid-to-serum total protein ratio.

Calculate the fluid-to-serum LD ratio.

Classify this pleural fluid specimen as a transudate or exudate and state two physiologic mechanisms that can cause this type of effusion.

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