Respiratory medicine: tuberculous pleural effusion: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Respiratory medicine: tuberculous pleural effusion

Sample item

A 25-year-old has a unilateral pleural effusion. Pleural fluid is an exudate with lymphocyte predominance. Which additional finding best supports tuberculosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Adenosine deaminase above 40 IU/L

A lymphocytic exudate with raised adenosine deaminase is highly suggestive of tuberculous pleurisy, especially in high-burden countries like India. Pleural biopsy with granulomas or culture confirms it. Empyema shows neutrophils and low pH, and chylothorax shows high triglycerides.

Option by option

  • A. Milky appearance with high triglycerides

    High triglycerides define chylothorax.

  • B. Neutrophil predominance with pH below 7.2

    Neutrophils with low pH suggest empyema or complicated parapneumonic effusion.

  • C. Adenosine deaminase above 40 IU/L (correct)

    Correct. High ADA with lymphocytes suggests tuberculous effusion.

  • D. Low protein transudate

    A transudate is typical of heart failure or cirrhosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Adenosine deaminase above 40 IU/L. A lymphocytic exudate with raised adenosine deaminase is highly suggestive of tuberculous pleurisy, especially in high-burden countries like India.

Why is "Milky appearance with high triglycerides" not the answer?

High triglycerides define chylothorax.

Why is "Neutrophil predominance with pH below 7.2" not the answer?

Neutrophils with low pH suggest empyema or complicated parapneumonic effusion.

Why is "Low protein transudate" not the answer?

A transudate is typical of heart failure or cirrhosis.

What concept does this question test?

It tests Respiratory medicine: tuberculous pleural effusion in General Medicine. Pleural biopsy with granulomas or culture confirms it. Empyema shows neutrophils and low pH, and chylothorax shows high triglycerides.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory medicine: tuberculous pleural effusion?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.