skip to main content

Tuberculous pleuritis — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRespiratory InfectionsTuberculous pleuritisSCE Respiratory

A 34-year-old man from the Indian subcontinent has fever, pleuritic pain and a lymphocytic exudative pleural effusion. CT shows pleural enhancement without lung mass. Pleural fluid culture is pending and sputum is smear negative. What is the most appropriate investigation?

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

Reveal the answer and explanation

Correct answer: E — Pleural biopsy for histology and mycobacterial culture

Tuberculous pleuritis often presents as a lymphocytic exudate, and pleural biopsy improves diagnostic yield by providing histology and culture. D-dimer, spirometry and sleep testing do not investigate the pleural syndrome. Sputum can be negative, so tissue sampling is important when suspicion remains high.

Reference: NICE NG33; BTS Pleural Disease Guideline 2023