American Association of Critical-Care Nurses (AACN) Certification Practice Test

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What characterizes a chylous effusion?

Clear appearance with low protein count
Milky appearance with a high triglyceride count and mature lymphocytes
Red appearance due to blood presence
Cloudy appearance with low cellularity

The correct answer is: Milky appearance with a high triglyceride count and mature lymphocytes

A chylous effusion is characterized by its distinctive milky appearance, which is primarily due to the presence of chyle, a fluid that contains lymph and emulsified fats. This type of effusion is rich in triglycerides, often exceeding 110 mg/dL, and it typically contains a high number of mature lymphocytes. The elevated triglyceride levels indicate that the effusion originates from the lymphatic system, often in contexts like thoracic duct obstruction or trauma. In contrast, other types of effusions present differently. A clear effusion with a low protein count would suggest a transudate, often seen in conditions like heart failure or cirrhosis. The presence of blood leading to a red appearance indicates a hemorrhagic effusion rather than chyle. A cloudy appearance with low cellularity does not align with the characteristics of chylous effusions, which do have notable cellular and lipid content. Therefore, the attributes of a chylous effusion align specifically with the increasing triglycerides and lymphocyte presence, defining it uniquely among other effusion types.