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Complicated parapneumonic effusion — RCPSC EM MCQ

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ModerateRespiratory emergenciesComplicated parapneumonic effusionRCPSC EM

A 36-year-old with fever, pleuritic pain and dyspnoea has a large loculated pleural effusion on ultrasound. WBC is 18, CRP is high, and oxygen saturation is 92% on room air. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Diagnostic thoracentesis with pleural pH, glucose, Gram stain and culture

Suspected complicated parapneumonic effusion requires pleural fluid analysis; low pH/glucose or pus supports drainage.

Reference: Canadian Thoracic Society pleural infection practice; emergency respiratory standards