A 77-Year-Old Man Comes to the Emergency Department Due to Cough

question 575

Multiple Choice

A 77-year-old man comes to the emergency department due to cough, shortness of breath, sharp chest pains, night sweats, and fatigue for 4 days.  Temperature is 38.3 C (101 F) , blood pressure is 110/62 mm Hg, pulse is 106/min, and respirations are 24/min.  The patient appears ill.  Neck veins are nondistended.  There is decreased chest expansion on the right side.  Auscultation reveals decreased breath sounds over the right lung base.  Chest imaging shows a right lower lobe infiltrate and a small, free-flowing pleural effusion on the right side.  Thoracentesis is performed.  Laboratory results are as follows: Which of the following processes best explains this patient's pleural fluid findings?

• A)Elevated pulmonary capillary hydrostatic pressure
• B)Movement of sterile exudate into the pleural space
• C)Obstruction of lymphatic pleural fluid drainage
• D)Reduced pleural capillary oncotic pressure

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