Collection of lymph fluid in the pleural space

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Explanation

Chylothorax is the medical term for the accumulation of chyle, which is lymphatic fluid, in the pleural space (the space between the lungs and the chest wall).
This fluid is typically milky in appearance due to its high content of triglycerides (fats) absorbed from the small intestine and transported via the lymphatic system.
The most common causes are trauma to the thoracic duct (often during chest surgery) or obstruction by a tumor, such as a lymphoma.

Option A: Hemothorax refers to the collection of blood in the pleural space, not lymph fluid.
Option B: Pneumothorax is the presence of air or gas in the pleural space, which can cause the lung to collapse. It does not involve fluid.
Option D: This option is incorrect because a correct term, Chylothorax, is provided in the options.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathological collections in the pleural space as background academic context rather than a clinical decision trigger.
Nurses must accurately assess and document the color, consistency, and volume of chest tube drainage. Milky white drainage is a classic sign of chylothorax and must be reported to the physician immediately.
Management of chylothorax often involves dietary changes to reduce chyle production. Nurses play a key role in patient education regarding a low-fat or medium-chain triglyceride (MCT) diet.
What if? If the chest tube drainage was bright red and voluminous (e.g., greater than 200 mL/hr), the diagnosis would shift to an active Hemothorax, a medical emergency requiring immediate intervention to control bleeding, possibly through surgery, rather than dietary management.

How to Approach the Question

First, identify the key terms in the question stem: 'collection', 'lymph fluid', and 'pleural space'.
The core of the question is to find the specific medical term for 'lymph fluid in the pleural space'.
Analyze the prefixes and roots of the options. 'Hemo-' relates to blood, 'pneumo-' relates to air, and 'chylo-' relates to chyle (lymph fluid). 'Thorax' refers to the chest cavity.
Match the definition from the stem to the correct term. 'Chyle' is lymphatic fluid, so 'Chylothorax' is the logical answer.
Eliminate the other options based on their definitions: Hemothorax (blood) and Pneumothorax (air) are incorrect.
Since a correct option exists, 'None of the above' is also incorrect.

Concept Tested & Keywords

Qp99F30Sr5bw_uSTg-H294

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 2 (215-514) p. 77-79

E6 Medicine Harrison 22e Part 2 p. 174-176

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 497-499

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