Pleural Effusion Quiz: Fluid In The Lungs

1. What is the primary pathophysiologic mechanism that leads to pleural effusion formation?

Increased capillary hydrostatic pressure or decreased plasma oncotic pressure

Only bacterial infection of the pleural space

Spontaneous rupture of lung alveoli

Excessive pleural fluid absorption

2. According to Light's criteria, which finding indicates an exudative pleural effusion?

Pleural fluid LDH less than 200 IU/L

Pleural fluid protein-to-serum protein ratio greater than 0.5

Pleural fluid glucose greater than 60 mg/dL

Normal pleural fluid pH (7.35–7.45)

3. A patient with congestive heart failure develops bilateral pleural effusions. What type of effusion is this most likely to be?

Exudative, due to increased vascular permeability

Transudative, due to increased hydrostatic pressure

Hemorrhagic, requiring immediate intervention

Chylous, indicating lymphatic obstruction

4. Which imaging modality is most sensitive for detecting small pleural effusions?

Chest X-ray in posteroanterior position

Chest ultrasound

CT scan of the thorax

Fluoroscopy

5. What is the minimum volume of pleural fluid required to be visible on a standard upright chest X-ray?

50–100 mL

200–250 mL

500–750 mL

1000–1500 mL

6. A thoracentesis sample shows low glucose (

Uncomplicated parapneumonic effusion

Rheumatoid arthritis-associated effusion

Empyema or complicated parapneumonic effusion

Malignant effusion

7. Which malignancy most commonly causes pleural effusion?

Lung cancer

Breast cancer

Gastric cancer

Pancreatic cancer

8. A patient presents with pleuritic chest pain, dyspnea, and a pleural effusion after recent myocardial infarction. What is this condition called?

Dressler syndrome

Post-cardiac surgery syndrome

Acute coronary syndrome

Pulmonary embolism

9. In a patient with suspected malignant pleural effusion, what is the sensitivity of pleural fluid cytology on the first thoracentesis?

10–20%

30–40%

60–70%

90%+

10. What is a pleural effusion that contains chylomicrons or has a triglyceride level greater than 110 mg/dL classified as?

Pseudochylous effusion

Chylous effusion

Lipemic effusion

Hemorrhagic effusion

11. A 65-year-old with cirrhosis develops a transudative pleural effusion. Which mechanism best explains this finding?

Decreased serum albumin and increased portal pressure

Increased pleural vascular permeability

Lymphatic obstruction by tumor

Acute bacterial infection

12. When is tube thoracostomy (chest tube) indicated in the management of parapneumonic effusion?

In all parapneumonic effusions

Only in empyema or complicated parapneumonic effusion

Only in transudative effusions

Never; thoracentesis alone is sufficient

13. Which finding on pleural fluid analysis suggests a diagnosis of systemic lupus erythematosus (SLE)?

LE cells or antinuclear antibodies in pleural fluid

Very low glucose (

Positive bacterial culture

Elevated cholesterol level

Submit

15. What is the primary treatment goal for a symptomatic malignant pleural effusion that recurs after thoracentesis?

Pleurodesis or indwelling pleural catheter

Repeated thoracentesis every 2 weeks

Diuretic therapy alone

Observation without intervention

Pleural Effusion Quiz: Fluid in the Lungs