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Tuberculosis
22%
34/155
Cirrhosis
37%
58/155
Pancreatitis
9%
14/155
Chylothorax
20%
31/155
Nephritic syndrome
6%
9/155
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This patient has a right-sided pleural effusion with thoracentesis results consistent with a transudative process such as cirrhosis. Transudative pleural effusions are caused by increased hydrostatic pressure or decreased oncotic pressure in blood vessels. Findings include clear fluid with low protein content, low LDH, and specific gravity less than 1.012. Etiologies include cirrhosis, congestive heart failure, and nephrotic syndrome. Figure/Illustration A is a chest radiograph with evidence of right-sided pleural effusion (yellow arrow). Note, on the left side, there is a sharp costophrenic angle (red arrow) that is present when there is no pleural effusion. Incorrect Answers: Answer 1: Tuberculosis would lead to an exudative pleural effusion that is characterized by cellular, protein rich fluid with a specific gravity greater than 1.012. Answer 3: Pancreatitis and other abdominal disorders lead to an exudative pleural effusion. Answer 4: Chylothorax occurs most commonly in the setting of trauma to the thoracic duct and would present with an exudative pleural effusion with a milky appearance and increased triglycerides. Answer 5: Nephritic syndrome does not commonly cause effusions. However, nephrotic syndrome is associated with a transudative pleural effusion. Bullet Summary: A transudative pleural effusion presents on thoracentesis with findings of clear fluid with low protein content, low LDH, and specific gravity less than 1.012.
3.6
(11)
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