MEDizzy
MEDizzy
USMLE
General Nephrology
A 28-year-old woman presents to the emergency department with a recent episode of coughing up some blood, frequent nosebleeds, and now decreased urine output. On physical examination, a nasal mucosa ulcer is seen on inspection and the remainder of the examination is normal. Her urinalysis is positive for protein and red cells consistent with a GN. The CXR shows two cavitary lesions and her serology is positive for antineutrophil cytoplasmic antibodies (ANCA). Which of the following is the most likely diagnosis?
Explanation
Explanation(B) This man has a noninflammatory effusion likely from the trauma caused by the fall. In the noninflammatory category, the fluid is transparent, WBC 200–2000/mL (<25% PMNs), glucose is normal, and LDH is low. Another cause for a noninflammatory effusion is osteoarthritis.
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