Question of the Week # 344

344) A 65 year old man with history of smoking is recently diagnosed with Stage IA non-small cell lung cancer of the right lung. He has no other significant past medical history. He was subsequently admitted and underwent wedge lower left pulmonary resection via. Video-assisted thoracic surgery (VATS). On the 2nd postoperative day, a chest x-ray reveals right sided pleural effusion was detected on chest X-Ray. On examination, he is afebrile.  Breath sounds are decreased on the right side and there is dullness to auscultation. A thoracentesis is performed and a chest tube is inserted. Which of the following is most likely to be found on this pleural fluid analysis?

A) Low glucose

B) Elevated LDH > 1000 IU/L

C) High Amylase

D) Cholesterol level > 200mg%

E) Triglycerides > 110mg%

6 Responses

  1. A) Low glucose

  2. B

  3. E

  4. E
    Chylothorax post pneumonectomy or toracic surgery? A, B, C, D..are exudate causes…

  5. When it will be live clinical review live and can I listen you lectures on I phone lana

  6. Post thoracic surgery via VATS with effusion that needs tube thoracostomy. Why?
    What are the causes of pleural effusion… Transudate, exudate, hemothorax, cylothorax. Transudate – CHF, hypoproteinemia,(Patient doesn’t have any history). Exudate: parapneumonic, malignancy (patient is afebrile and exclude pneumonia, and stage IA is localized and not reached to pleura yet and it is too early for malignant pleural effusion). Because of Thracic surgery it can cause trauma – hemothorax and chylothorax , both needs tube thoracostomy. Here chylothorax is only possibility in answer option.
    Answer E

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