IM NBME

[super_mom]

A friend of mine needed help answering this question on here IM NBME for step 2ck. here is he question below she chose C but got it wrong.

A 54yr old woman with diabetes mellitus has had increasing shortness of breath and ankle swelling for 3 weeks. she has a nonproductive cough and discomfort when sleeping on fewer than four pillows. There is an S3 with dullness and diminished sounds at the base of the right hemithorax. which os the following is the most recent finding on examination of pleural fluid?

a) erythrocyte count greater than 15,000/mm^3
b) glucose concentration approximately equal to serum glucose concentration
c) lactate dehydrogenase activity greater than or equal to 200U/L
d)neutrophilic leukocyte count greater than 1000/mm^3
e) protein accumulation greater than or equal to 3g/dl

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[doc0610]

It's B, if i am not wrong. This is transudative effusion so only option B is valid. The question had given you the serum values for LDH and protein so that help calculate lights criteria.

a) well, i am assuming this would be seen in trauma or cancer
c) it would have been more than 0.6 ( the ratio if you calculate that)
d) this is infection
e) again, would be more than 0.5

 

[super_mom]

It's B, if i am not wrong. This is transudative effusion so only option B is valid. The question had given you the serum values for LDH and protein so that help calculate lights criteria.

a) well, i am assuming this would be seen in trauma or cancer
c) it would have been more than 0.6 ( the ratio if you calculate that)
d) this is infection
e) again, would be more than 0.5

thank you i will send to her.