A 70-year-old man with a 15-year history of COPD and systolic heart failure (EF 35%) presents with progressive dyspnea. Vital signs: BP 148/92, HR 102, RR 24, SpO2 88% on room air. Chest X-ray shows moderate bilateral pleural effusions. Thoracentesis yields clear, transudative fluid with protein 2.2 g/dL and LDH 180 IU/L. No fever or recent infection. Which mechanism best explains this effusion?
- A)Obstruction of lymphatic drainage by mesothelioma
- B)Leak of pancreatic enzymes into the pleural space
- C)Increased hydrostatic pressure causing a transudateGABARITO
- D)Increased vascular permeability causing an exudate
- E)Rupture of the thoracic duct causing chylothorax
Explicação
Increased hydrostatic pressure causing a transudate is correct. Congestive heart failure raises capillary hydrostatic pressure, leading to low protein pleural fluid accumulation. Bilateral clear effusions with low protein and low lactate dehydrogenase strongly... Ver explicação completa e trilha adaptativa →