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* Qestion?
 #835855  
  akshaya007 - 01/04/17 10:32
 
  A 67-year-old man presents to the emergency department with dyspnea that has been worsening over the last 2 to 4 days. His chest x-ray shows a large pleural effusion. After admission to the hospital, treatment with diuretics produces only a minimal response in his respiratory status. He undergoes a thoracentesis, which did not improve his symptoms. He quit smoking 3 years ago but had a 120-pack-year smoking history until then. Currently, he has a temperature of 100..3 F and a respiratory rate of 24/min. He has dullness to percussion three-quarters of the way up on one side. Laboratory studies on the pleural fluid show: LDH 1, 505 mg/dL, white cells 500/mm3, red cells 1,030/mm3, and glucose level 76 mg/dL. No bacteria is seen on Gram stain, and the pleural fluid has a pH of 7.5. The cytology is positive for malignant cells. Repeat chest x-ray shows a large pleural effusion on one side. What is the next best step in the management of this patient?

(A) Serial thoracentesis
(B) Video-assisted thoracoscopy
(C) Chemotherapy and radiotherapy
(D) Pleurodesis with doxycycline
(E) Chest tube placement
 
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* Re:Qestion?
#3322873
  sinnombre15 - 01/04/17 10:40
 
  D.
Pleurodesis is the best choice for malignant effusion
 
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