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Week 20

 

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Quiz 20 Context:

A 19-year-old female presents to the emergency room with a complaint of dyspnea and a non-productive cough, which have both slowly progressed over the past 2 weeks. The patient was in good health until several weeks ago when she was involved in an automobile accident. This resulted in significant traumatic injury and she underwent 3 separate operative procedures to address thoracic and abdominal sequelae from the trauma. She was only recently discharged from the hospital following the most recent surgery. The remainder of her history is noncontributory.

Physical examination reveals dullness to percussion at the left base.

A chest film is obtained, and it reveals a large left pleural effusion.

The patient subsequently undergoes diagnostic thoracentesis. The fluid obtained is pictured above. Laboratory examination of the fluid reveals a triglyceride level of 119 mg/dL.

The following are all common causes of this condition EXCEPT:

  1. Trauma (including surgery)
  2. Subclavian vein thrombosis
  3. Lymphangiomyomatosis
  4. Intestinal lymphangiectasia
  5. Urinothorax

 

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Center for Continuing Education | 9500 Euclid Avenue, KK31, Cleveland, OH 44195