Ed complaining of dyspnea and a heavy feeling in chest


Problem: A 67-year-old male comes into the ED complaining of dyspnea and a heavy feeling in his chest. He reports that over the past month he has become more easily "winded" to the point that he now sleeps in his living room because he can't make it up the stairs. A review of systems is notable for headaches and fatigue. On physical exam you note decreased breath sounds and a dullness to percussion on the right. A chest radiograph is obtained, which shows a right-sided pleural effusion. Thoracocentesis is performed and the fluid is analyzed. What indicator would confirm the presence of exudate in this case? * Number of cells less than 15 Negative Rivalta's test Total protein in the pleural fluid below 25 g/L Total protein in the pleural fluid exceeding 30 g/L Specific gravity below 1015

 

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