The Daily PANCE and PANRE Extended Edition: Question 20

A 44-year-old male presents with a fever, a cough productive of brownish sputum, rigors and lethargy for seven days. A chest x-ray reveals a right middle lobe infiltrate and a right-sided pleural effusion. A thoracentesis is performed. Which of the following results from the pleural fluid analysis would be most characteristic of acute pneumonia?

  1. pleural fluid: serum LDH ratio >0.6
  2. pleural fluid specific gravity < 1.006
  3. pleural fluid without protein
  4. pleural fluid without LDH
  5. pleural fluid: serum protein ratio <0.5

Answer: A

Pleural fluid: serum LDH ratio >0.6

The question suggests bacterial pneumonia. The pleural fluid should have high LDH (pleural > serum), a high specific gravity (lots of "stuff' in the fluid), a large amount of protein (WBC's, bacteria, and "stuff)

Know Your Content Blueprint