A 72-year-old man with ischemic cardiomyopathy presents with progressive dyspnea and bilateral lower extremity edema. Vital signs: BP 92/58, HR 104, RR 22, SpO2 88% on room air. Chest radiograph shows bilateral pleural effusions with elevated jugular venous pressure noted on exam. Thoracentesis yields clear, serous fluid with protein 2.2 g/dL, LDH 180 IU/L, and negative gram stain. No fever documented. Which of the following best explains this pleural fluid finding?
- A)Increased hydrostatic pressure producing a transudateGABARITO
- B)Immune complex deposition in pleural capillaries
- C)Increased vascular permeability due to histamine release
- D)Obstruction of lymphatics by metastatic carcinoma producing an exudate
- E)Neutrophil mediated enzymatic digestion of tissue
Explicação
Heart failure raises capillary hydrostatic pressure and leads to movement of relatively protein poor fluid into body cavities, producing a transudate. The low protein and low LDH described here support a transudative pleural effusion rather than inflammatory e... Ver explicação completa e trilha adaptativa →