A patient has a pleural fluid with 2000 WBCs per mL. Seventy ...

[tichca]

A patient has a pleural fluid with 2000 WBCs per mL. Seventy percent of the cells are neutrophils. Which of the following is most likely?
 
  a. Normal fluid
  b. Transudate on a patient with a pleural bacterial infection
  c. Exudate on a patient with a pleural bacterial infection
  d. Exudate on a patient with heart failure

Question 2

A CSF is equally bloody in all tubes collected and has a yellowish supernatant. On the differential, macrophages with hemosiderin are noted. Which of the following is most likely?
 
  a. Bacterial meningitis
  b. Viral meningitis
  c. Subarachnoid hemorrhage
  d. Traumatic tap

[aloop]

Answer to Question 1

ANS: C
Exudates are formed in response to an infection (viral or bacterial), malignancy, pulmonary embolus, and systemic lupus erythematosus. They generally have a white count greater than 1000/mL. Because the primary cells seen in this fluid are neutrophils, the infection is bacterial.

Answer to Question 2

ANS: C
Because all tubes were equally bloody, it indicates hemorrhage. If it had been a traumatic tap, then there should have been a gradual decrease in the number of red cells in successive tubes with gradual clearing. The yellow tinge to the supernatant suggests a subarachnoid hemorrhage.

[tichca]

Thanks for the timely response, appreciate it

[ktidd]

Excellent