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 BOF 128

 

   

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BOF: 128

A 72 year old female presented with shortness of breath and a sharp, pleuritic chest pain localized to the left lower chest wall with radiation to the left shoulder. No significant past medical history.

On examination she was found to have a left sided pleural effusion and this was confirmed on chest-ray. An ECG was normal

Pleural aspiration

White blood cell count of 125 per ÁL (55% polymorphonuclear leukocytes, 45% monocytes)

Lactic acid dehydrogenase of 1,652 U/L

Total protein of 5.8 g/dL

pH 7.01

Glucose 1.2 mmol/L

Gram stains and acid-fast stains of the pleural fluid were negative

Cytology large numbers of acute inflammatory cells without evidence for malignancy

In this patient

In this patient which one of the following would you arrange to substantiate the diagnosis?

a)    Pleural fluid rheumatoid factor

b)    Pleural fluid amylase

c)     Pleural fluid anti nuclear factor

d)    Thoracoscopy

e)    Gastrograffin swallow

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