A 66-year-old man comes to the emergency department due to increasing shortness of breath over the past 5 days. The patient reports feeling dyspneic while lying flat and has been sleeping upright in his recliner. On physical examination, jugular venous distension is present. Heart sounds are normal. Decreased breath sounds and dullness to percussion can be heard at the bilateral bases. Pitting edema is present in the bilateral lower extremities. Chest x-ray shows cardiomegaly and bilateral pleural effusions. Serum protein is 6 g/dL and serum lactate dehydrogenase (LDH) is 60 U/L. Which of the following sets of pleural fluid findings is most likely to be seen in this patient?

Question

A 66-year-old man comes to the emergency department due to increasing shortness of breath over the past 5 days. The patient reports feeling dyspneic while lying flat and has been sleeping upright in his recliner.  On physical examination, jugular venous distension is present.  Heart sounds are normal.  Decreased breath sounds and dullness to percussion can be heard at the bilateral bases.  Pitting edema is present in the bilateral lower extremities.  Chest x-ray shows cardiomegaly and bilateral pleural effusions.  Serum protein is 6 g/dL and serum lactate dehydrogenase (LDH) is 60 U/L.  Which of the following sets of pleural fluid findings is most likely to be seen in this patient?

Quizplus · Accepted Answer

Eductional Objective: Transudative pleural effusions result from increased intracapillary pressure (eg, heart failure) and exudative effusions develop from inflammatory disruption of the vascular membrane.  Transudative pleural effusions have low fluid/serum ratios of total protein and lactate dehydrogenase and low absolute levels of lactate dehydrogenase compared to exudative effusions.

A 66-Year-Old Man Comes to the Emergency Department Due to Increasing