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5. Thoracentesis

The only abnormality seen on the CT scan is a large left pleural effusion. Although the white blood cell count is elevated with a left shift, this is nonspecific and does not necessarily indicate an infection such as empyema or a blood disorder where bone marrow aspiration might be helpful. Congestive heart failure is a consideration in a patient short of breath but a solitary left pleural effusion without a right pleural effusion would be unusual. There is no pleural mass. Unless contraindicated, the first step in evaluating a pleural effusion is thoracentesis.

A diagnostic thoracentesis was performed which was grossly bloody.

Which of the following is true regarding unilateral bloody pleural effusions? (Click on the correct answer to proceed to the fourth of six panels)

  1. About half are secondary to malignancy
  2. Are often associated with traumatic thoracentesis
  3. Can be seen with pulmonary embolism
  4. 1 and 3
  5. All of the above

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