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17104 Medicine

A 63-year-old man who has been previously healthy is admitted to the hospital with a 2-day history of cough, rigors, fever, and right-sided pleuritic chest pain. Chest x-ray shows consolidation of the right lower lobe (RLL) and a free-flowing right pleural effusion. Thoracentesis is performed, and the pleural fluid has the following characteristics:Cell count=1110/mm3Glucose=75 mg/dL (serum glucose=85 mg/dL)Protein=4.0 g/dL (serum protein=7.0 g/dL)LDH=400 U/Lserum LDH=200 U/L, normal=100-200 U/LpH=7.35What is the pathogenesis of the pleural effusion?

AIncrease in hydrostatic pressure
BDecrease in oncotic pressure
CIncreased permeability of visceral pleural membrane capillaries
DBacterial infection in the pleural space
Medicine
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17107 Medicine

A 27-year-old man has a history of low back pain and stiffness. After several months of mild symptoms, he notes more severe stiffness at night and hip pain. On physical examination, there is paravertebral muscle tenderness and limited flexion of the lumbar spine. X-ray of the lumbar spine shows sacroiliitis. In addition to recommending physiotherapy and exercise, which of the following is the most appropriate next step in management?

ANSAID therapy
Bphenylbutazone
Cazathioprine
Dacetaminophen
Medicine
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