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Non-expandable lung — SCE Respiratory MCQ

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HardPleural diseaseNon-expandable lungSCE Respiratory

A 75-year-old man undergoes therapeutic aspiration of a chronic large pleural effusion. After 1.5 L is removed he develops chest tightness and persistent cough, and pleural pressure monitoring shows a steep fall. Post-procedure radiograph shows no pneumothorax but the lung has not fully expanded. The effusion had been present for at least six months. What is the most likely diagnosis?

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Correct answer: C — Non-expandable lung

The best answer is “Non-expandable lung”. The clinical pattern, physiology and imaging described are most consistent with Non-expandable lung. The competing diagnoses may share individual findings, but do not account for the complete combination in the stem. The remaining choices—“Tension pneumothorax, with clinical reassessment”, “Acute pulmonary embolism”, “Pleural fluid contamination”, “Cardiogenic pulmonary oedema”—are credible in related respiratory presentations, but each addresses a different diagnostic, staging or management decision and does not fit the decisive findings and pathway position in this stem.

Reference: British Thoracic Society guideline for pleural disease: https://thorax.bmj.com/content/78/Suppl_3/s1