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Bilateral pleural effusion

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Bilateral pleural effusion

  1. 1. A Lady with Underlying Chronic Renal Disease presented with Shortness of BreathQuestions Notes To differentiate exudates vs. transudate- Light criteria transudate 1) Describe the finding in the chest x ray - Pleural fluid to serum protein more than erum 2) What is your radiological diagnosis 0.5 3) What is your provisional and differential - Pleural fluid to serum LDH more than diagnosis 0.6 - Pleural fluid LDH > 2/3rd upper limit of normal serum LDH.Answer 1) Findings on CXR Hemorrhagic pleural effusion - Blunted of right cardiophrenic and - Lung ca, pulmonary infarction, TB, costophrenic angle pneumonia, trauma. - Blunted left costophrenic angle - Trachea is not shifted Differential diagnosis pleural effusion - Opacity at right lung field. Vascular Pulmonary embolism Infection Pneumonia, TB, Dengue Trauma Hemothorax 2) Bilateral pleural effusion Autoimmune SLE 3) Diagnosis Metabolic Uraemia, Provisional: Bilateral pleural effusion hypoalbuminaemia secondary to fluid overload Idiopathic Sarcoidosis Neoplasm Lung ca, Meig’s sydrome Differential of bilateral pleural effusion Connective tissue dz rheumatoid arthritis, - Heart problem lupus - Liver problem Drugs Amiodarone, - Neurogenic APO Cyclophosphamide, bromocriptine - Sub arachnoid hemorrhage Endocrine Myxedema - SIADH Others Fluid overload secondary to heart, renal or liver dz.

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