Author Question: A patient has a pleural fluid with 2000 WBCs per mL. Seventy percent of the cells are neutrophils. ... (Read 40 times)

tichca · **on:** Jun 25, 2018

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 · **Reply #1 on:** Jun 25, 2018

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.