ABP Pediatric Hospital Medicine Practice Questions - ABP Pediatric Hospital Medicine Subspecialty Certification Examination Exam

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A 3-year-old with pneumonia has a large parapneumonic effusion. Pleural fluid analysis shows pH 7.05, glucose 30 mg/dL, and LDH 1500 IU/L. The most appropriate next step is:

Observation with continued IV antibiotics alone Chest tube drainage with or without intrapleural fibrinolytics Needle thoracentesis only, no drainage Thoracotomy with decortication as first-line

Correct Answer:

Chest tube drainage with or without intrapleural fibrinolytics

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