Correct!
2. The whitish area in the region of the liver most likely represents a metastasis

The CT shows bilateral pleural effusions right larger than left. By convention CT scans are shown as if viewing from the feet towards the head, i.e., the right side of the patient is displayed on the left. The patient’s image is from a contrast-enhanced CT scan and the whitish area is a blood vessel.

Management of pleural effusions usually begins with thoracentesis to separate transudates from exudates (4).

A thoracentesis was performed and yielded pale yellow clear fluid with the following values:

• Negative cytology
• Pleural fluid protein 3.4 gm/dL
• Pleural fluid LDH 87 IU/L

Which of the following is false?

1. The values are most consistent with a transudate
2. 15-20% of pleural effusions due to heart failure are exudates
3. Diuretics increase the proportion of exudative effusions in heart failure
4. Elevated adenosine deaminase in the pleural fluid is diagnostic of heart failure
5. Pleural fluid glucose is usually normal in heart failure

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