Pleural effusion: The Daily PANCE Blueprint
Which of the following is the most common cause of exudative pleural effusions in the United States?
A. Heart failure
B. Cirrhosis
C. Pneumonia
D. Cancer
E. Tuberculosis
Answer and topic summary
The answer is C. Pneumonia
Pneumonia is the most common cause of exudative pleural effusions in the U.S. Other causes of exudates include cancer, tuberculosis, and connective tissue disease. Causes of transudates include CHF and cirrhosis. Clinical features of pleural effusions include shortness of breath, hypoxia, and diminished breath sounds. On CXR you may see blunting of costophrenic and cardiophrenic angles. The gold standard for diagnosing pleural effusions is pleural fluid analysis from US-guided thoracentesis. The fluid obtained from the thoracentesis should be sent for studies: pH, glucose, LDH, protein, cytology, cell count/diff, gram stain, and culture. Light’s criteria is what we use to distinguish transudative vs exudative pleural effusions:
- PF protein /serum protein ratio > 5
- PF LDH / serum LDH ratio > 6
- PF LDH > two-thirds the upper limit of normal for serum LDH (around ~200)
View blueprint lesson
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Pulmonary ⇒ ⇒
Also covered in the General Surgery and Emergency Medicine PAEA EOR topic lists
