USMLE Forum Archives - USMLE Step 3 - IM 9
IM 9
bingousmle - 06-20-10 05:59
A 62-year-old man presents to the ED with gradual dyspnea over the last few weeks. He reports that he is a daily smoker and has not seen a physician in years. Upon physical examination, there are decreased breath sounds on the right as compared to the left. A chest radiograph indicates blunting of the right costophrenic angle with a fluid line. A thoracentesis is performed. Given this patient’s history, which of the following most likely
describes his effusion?
a. Transudative effusion
b. Exudative effusion
c. Transudative and exudative effusion
d. Lactate dehydrogenase < 200 U
e. Fluid-to-blood protein ratio < 0.5
bingousmle - 06-20-10 05:59
A 62-year-old man presents to the ED with gradual dyspnea over the last few weeks. He reports that he is a daily smoker and has not seen a physician in years. Upon physical examination, there are decreased breath sounds on the right as compared to the left. A chest radiograph indicates blunting of the right costophrenic angle with a fluid line. A thoracentesis is performed. Given this patient’s history, which of the following most likely
describes his effusion?
a. Transudative effusion
b. Exudative effusion
c. Transudative and exudative effusion
d. Lactate dehydrogenase < 200 U
e. Fluid-to-blood protein ratio < 0.5
The correct answer and explanation will be available after you answer.
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#2
Re: IM 9
bingousmle - 06-20-10 06:39 My answer is: b.
Causes for exudative effusions infection, connective tissue diseases, neoplasm, pulmonary emboli, uremia, pancreatitis, esophageal rupture, postsurgical, trauma, and drug-induced. Pleural fluid analysis includes LDH, glucose, protein, amylase, cell count, Gram stain, culture, and cytology.
#3
Re: IM 9 babbu5508 - 06-20-10 14:19 My answer is: b.
exudative effusion...decreased breath sounds, blunting of the right costophrenic angle, daily smoker with gradual dyspnoea
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