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Quizzes > Health & Medicine > Diseases & Conditions

Think You Know Pleural Effusion? Take the Quiz!

Dive In: Master Pleural Effusion Symptoms with This Quick Quiz

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art lungs with fluid drops on sky blue background prompt pleural effusion quiz

Looking to test your mastery of lung fluid management? Our free pleural effusion quiz puts you in the clinician's seat, challenging you to spot pleural effusion symptoms, trace common pleural effusion causes, and nail the pleural effusion diagnosis process. With cimanim-enhanced case studies and targeted prompts, you'll interpret chest imaging, assess thoracentesis criteria, and review key lab values in minutes. Afterward, expand your expertise with thorax and lungs insights or take the do i have pleurisy quiz . Whether you're prepping for exams or rounding with confidence, this pleural effusion test is your perfect practice. Dive in and start acing it now!

What best describes a pleural effusion?
Accumulation of air in the pleural space
Accumulation of fluid in the pleural space
Infection of the lung parenchyma
Inflammation of the pleura without fluid
Pleural effusion is an abnormal accumulation of fluid in the pleural space, the narrow gap between the visceral and parietal pleura around the lungs. It can result from conditions that affect fluid production or absorption, such as heart failure, infection, or malignancy. Recognizing pleural effusion is important for timely diagnosis and management. Mayo Clinic
Which symptom is most commonly reported by patients with pleural effusion?
Hemoptysis
Dyspnea
Fever
Wheezing
Dyspnea, or shortness of breath, is the most frequent symptom of pleural effusion due to reduced lung expansion and impaired gas exchange. Patients may also experience chest discomfort, but breathlessness is the hallmark. Prompt evaluation of dyspnea can lead to early detection of effusion. Radiopaedia
On physical examination of a pleural effusion, you would expect:
Hyperresonance to percussion
Dullness to percussion
Bronchial breath sounds over the effusion
Increased tactile fremitus
A pleural effusion dampens underlying lung resonance, producing dullness to percussion. Breath sounds and tactile fremitus are also decreased over the fluid. These signs help distinguish effusion from other chest pathologies. NCBI Bookshelf
Which chest X-ray finding is characteristic of a pleural effusion?
Kerley B lines
Costophrenic angle blunting
Honeycombing
Ground-glass opacities
Blunting of the costophrenic angle on an upright chest X-ray is the classic sign of pleural effusion, reflecting fluid accumulation at the lung base. Minor effusions may require lateral decubitus views. Recognizing this helps guide further evaluation. Radiopaedia
Which condition typically causes a transudative pleural effusion?
Pneumonia
Congestive heart failure
Rheumatoid arthritis
Malignancy
Transudative effusions result from systemic factors altering hydrostatic or oncotic pressures. Congestive heart failure is the most common cause of transudative effusion. Recognizing transudates directs clinicians toward treating the underlying systemic disorder. UpToDate
Which tool is used to differentiate transudative from exudative pleural effusions?
Spirometry
Computed tomography
Light's criteria
Pleural biopsy
Light's criteria use pleural and serum protein and LDH levels to classify effusions as transudates or exudates. An effusion meeting any of the criteria (e.g., fluid/serum protein >0.5) is considered exudative. This distinction guides diagnostic and therapeutic decisions. NCBI
Which imaging modality is most sensitive for detecting small pleural effusions?
Chest CT
Chest MRI
Ultrasound
PET scan
Ultrasound is highly sensitive for detecting small pleural effusions, even those under 100 mL. It can guide thoracentesis and assess loculations. It’s portable and radiation-free, making it ideal at the bedside. American Thoracic Society
According to Light's criteria, a pleural effusion is considered exudative if the pleural fluid protein to serum protein ratio exceeds:
0.3
0.5
0.7
1.0
Light's criteria designate an effusion as exudative if the pleural fluid/serum protein ratio is greater than 0.5. Other criteria include fluid/serum LDH >0.6 and pleural fluid LDH > two-thirds the ULN of serum LDH. This helps differentiate causes of effusion. UpToDate
Which of the following is the most common cause of exudative pleural effusion worldwide?
Malignancy
Congestive heart failure
Pneumonia
Nephrotic syndrome
Parapneumonic effusions associated with pneumonia are the most common exudative pleural effusions globally. In regions with high TB prevalence, tuberculosis also is a frequent cause. Identifying an infectious etiology is essential for targeted treatment. NCBI PMC
What is the most common cause of transudative pleural effusion in developed countries?
Rheumatoid arthritis
Congestive heart failure
Tuberculosis
Pulmonary embolism
In developed nations, congestive heart failure is the leading cause of transudative pleural effusions due to increased hydrostatic pressure. Management focuses on diuresis and optimizing cardiac function. Recognizing transudates avoids unnecessary invasive studies. NEJM
A pleural fluid LDH to serum LDH ratio above which value indicates an exudative effusion?
0.3
0.5
0.6
0.8
One of Light's criteria for exudative effusion is a pleural fluid to serum LDH ratio greater than 0.6. Elevated LDH in pleural fluid reflects increased capillary permeability or cell turnover. This criterion complements protein measurements. Radiopaedia
Which pleural fluid test is most useful for diagnosing malignant effusions?
Adenosine deaminase level
Cytology
Gram stain
pH measurement
Pleural fluid cytology examines cells for malignant features and is the first-line test for suspected malignant effusion. Its sensitivity is about 60%–70% on the first sample and increases with repeat sampling. Early cytology guides further management. NCBI PMC
Which is the most common complication of diagnostic thoracentesis?
Pneumothorax
Pulmonary embolism
Myocardial infarction
Stroke
Pneumothorax is the most frequently reported complication of thoracentesis, occurring in about 6%–10% of procedures. Ultrasound guidance significantly reduces this risk. Monitoring and prompt management are important to prevent clinical deterioration. NCBI PMC
A pleural fluid pH below which value suggests a complicated parapneumonic effusion requiring drainage?
7.25
7.35
7.2
7.45
A pleural fluid pH less than 7.2 in the context of infection indicates a complicated parapneumonic effusion or empyema, necessitating drainage. Acidic pH reflects bacterial metabolism and high cell counts. Early intervention improves outcomes. UpToDate
Which intervention is recommended for recurrent malignant pleural effusions to provide long-term symptomatic relief?
Repeated thoracentesis only
Chemical pleurodesis
High-dose diuretics
Empirical antibiotics
Chemical pleurodesis, often using talc, induces fibrosis to obliterate the pleural space and prevent fluid reaccumulation in recurrent malignant effusions. It provides sustained symptom relief. Patient selection and lung re-expansion are important for success. NEJM Review
Use of diuretic therapy prior to thoracentesis may cause which of the following errors in pleural fluid analysis?
False transudate classification
False exudate classification
Underestimation of LDH
Elevation of pleural pH
Diuretic use can concentrate proteins and LDH in pleural fluid, causing a transudative effusion to meet Light's criteria for exudate and be misclassified. Recognizing this limitation may prompt additional testing such as serum-fluid albumin gradient. UpToDate
Hepatic hydrothorax most commonly occurs on which side of the chest?
Right
Left
Bilateral
Equally on both sides
Hepatic hydrothorax, a pleural effusion due to cirrhosis and portal hypertension, occurs predominantly on the right side in over 80% of cases. This is attributed to anatomical defects in the right hemidiaphragm. Awareness guides diagnostic evaluation in cirrhotic patients with effusion. NCBI PMC
A chylous pleural effusion is characterized by:
High triglyceride content
Obstruction or disruption of the thoracic duct
Low lymphocyte count
Serum-pleural fluid albumin ratio <0.5
Chylous effusions arise from disruption or obstruction of the thoracic duct, leading to lymph-rich pleural fluid high in triglycerides (>110 mg/dL). Milky appearance and chylomicrons confirm the diagnosis. This often indicates malignancy or trauma. NCBI PMC
An elevated adenosine deaminase (ADA) level in pleural fluid is most suggestive of:
Tuberculous pleural effusion
Malignant effusion
Rheumatoid pleuritis
Congestive heart failure
Pleural fluid ADA levels above 40 U/L are highly suggestive of tuberculous pleural effusion, especially in high-prevalence regions. ADA reflects lymphocytic activity in TB. It helps differentiate TB from other exudative effusions. NCBI PMC
Which pleural fluid characteristic strongly suggests empyema rather than a simple parapneumonic effusion?
pH >7.5
Glucose level <40 mg/dL
Protein <2 g/dL
LDH <200 IU/L
Empyema is associated with low pleural fluid glucose (<40 mg/dL) due to high metabolic demand of bacteria and leukocytes. The fluid pH is also often <7.2 and LDH markedly elevated. These findings necessitate prompt drainage and antibiotics. UpToDate
A pleural fluid hematocrit that is more than 50% of the peripheral blood hematocrit defines:
Hemothorax
Chylothorax
Empyema
Hemorrhagic exudate
A pleural fluid hematocrit exceeding 50% of the blood hematocrit confirms a hemothorax, indicating significant bleeding into the pleural space. Hemorrhagic exudates have lower hematocrit. Recognition guides urgent management. NCBI Bookshelf
Which pleural fluid marker is most specific for identifying effusions due to heart failure?
NT-proBNP
Carcinoembryonic antigen
Adenosine deaminase
LDH
Elevated pleural fluid NT-proBNP is highly specific for heart failure–related effusions, distinguishing them from other causes when Light’s criteria are inconclusive. A cutoff around 1500 pg/mL offers high diagnostic accuracy. This biomarker guides management. American Journal of Respiratory and Critical Care Medicine
Which combination therapy has been shown to improve drainage of loculated pleural infections?
tPA plus DNase
Streptokinase alone
Urokinase alone
Talc pleurodesis
The combination of intrapleural tissue plasminogen activator (tPA) and DNase significantly improves fluid drainage and clinical outcomes in loculated pleural infections compared to fibrinolytics alone. This regimen breaks down fibrin and reduces fluid viscosity. It’s now widely recommended. NEJM
What is a key benefit of using pleural manometry during large-volume thoracentesis?
Prevention of re-expansion pulmonary edema
Measurement of pleural fluid glucose
Detection of malignant cells
Initial localization of effusion
Pleural manometry monitors intrapleural pressure during thoracentesis and helps prevent re-expansion pulmonary edema by avoiding excessive negative pressures. It also identifies noncompliant lungs, guiding safe drainage limits. This technique enhances procedural safety. American Thoracic Society
What is the approximate diagnostic yield of medical thoracoscopy for malignant pleural disease?
Greater than 90%
50%–60%
70%–80%
Less than 30%
Medical thoracoscopy (pleuroscopy) achieves diagnostic yields exceeding 90% for malignant pleural disease, making it a highly effective tool when needle biopsy and cytology are inconclusive. It allows direct visualization and targeted biopsy. Its safety and efficacy are well documented. NCBI PMC
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Study Outcomes

  1. Identify common pleural effusion causes -

    Distinguish between transudative and exudative etiologies by recognizing conditions like heart failure, infection, and malignancy.

  2. Recognize pleural effusion symptoms -

    Correlate clinical signs such as dyspnea, chest pain, fever, and diminished breath sounds with lung fluid accumulation.

  3. Interpret pleural effusion test results -

    Analyze imaging findings (X-ray, ultrasound, CT) and apply Light's criteria to fluid analysis for accurate diagnosis.

  4. Differentiate diagnostic approaches -

    Compare indications and techniques of thoracentesis, ultrasound-guided sampling, and advanced imaging methods.

  5. Apply clinical reasoning in quiz scenarios -

    Use case-based questions to reinforce diagnostic insights and enhance your understanding of pleural effusion management.

Cheat Sheet

  1. Fluid Dynamics & Starling Equation -

    When tackling a pleural effusion quiz, review the Starling equation (Qf = Kf[(Pc−Pi)−σ(πc−πi)]) to understand how hydrostatic and oncotic forces regulate pleural fluid formation, as detailed in Harrison's Principles of Internal Medicine. Remember the mnemonic "HOP on the Star" (Hydrostatic, Oncotic, Permeability) to recall key components affecting fluid balance.

  2. Transudate vs. Exudate & Light's Criteria -

    Use Light's criteria (pleural/serum protein ratio >0.5, LDH ratio >0.6, or pleural LDH >2/3 upper limit of normal) to distinguish transudative from exudative effusions, in line with American Thoracic Society guidance. A simple memory aid is "PEL" (Protein Exceeds Limit) to remember the key thresholds.

  3. Common Causes & Mnemonics -

    When studying pleural effusion causes, classify effusions as transudative (heart failure, cirrhosis, nephrotic syndrome) or exudative (pneumonia, malignancy, pulmonary embolism) to guide clinical reasoning. Use the mnemonic "CHAMP" (CHF, Hepatic, Albumin loss, Malignancy, Pneumonia) to quickly recall the top etiologies.

  4. Clinical Features & Physical Exam -

    Review pleural effusion symptoms like progressive dyspnea, pleuritic chest pain, cough, decreased breath sounds and dullness to percussion, as noted in UpToDate clinical guidelines. The phrase "Dry Squeak & Dull Leak" helps link auscultation findings with fluid accumulation on exam.

  5. Diagnostic Workup & CIMANIM Framework -

    Combine chest imaging (CXR, ultrasound, CT, MRI) with thoracentesis and pleural fluid analysis in your pleural effusion test protocol to optimize pleural effusion diagnosis. The "CIMANIM" (CXR, Imaging Modalities, Analysis, Needling, Interpretation, Management) approach streamlines decision-making and ensures no step is overlooked.

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