A 70-year-old male chronic alcohol abuser presented with severe central chest pain after persistent nausea vomiting. He found to have left sided pleural effusion. A diagnostic pleural aspiration was performed. Which of the following favor esophageal rupture diagnosis?
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الإجابة: C. Elevated pleural fluid amylase
Oesophageal rupture (Boerhaave, after forceful vomiting in an alcoholic) leaks salivary amylase into the (usually left) pleural space, so raised pleural amylase supports it. An LDH ratio of 0.4 suggests a transudate, and glucose would be low rather than high; a red colour is non-specific.
ليش كل خيار صح أو غلط
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A
ليش غلط
Raised pleural RBCs (a reddish fluid) suggest hemothorax when there is evidence of trauma, not esophageal rupture; raised amylase is the marker for rupture.
✓ 7• Pleural Diseases [Notes].pdf · p. 8 -
B
ليش غلط
A pleural LDH ratio below 0.6 is transudative; the lead finding for esophageal rupture is raised pleural amylase.
✓ 7• Pleural Diseases [Notes].pdf · p. 8 -
C
ليش صح
A raised pleural amylase suggests pancreatitis or esophageal rupture (salivary amylase leaking into the pleural space).
✓ 7• Pleural Diseases [Notes].pdf · p. 8 -
D
ليش غلط
The notes place esophageal rupture and pancreatitis under normal pleural glucose, identified by raised amylase; the glucose abnormalities listed are low, not high.
✓ 7• Pleural Diseases [Notes].pdf · p. 8
- المصدر
- Pleural effusion.pdf · p. 5
7• Pleural Diseases [Notes].pdf · p. 8 - المحاضرة
- Pleural Effusion & Pneumothorax · Pulmonology · Module B
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- Respi bank