A patient with nephritic syndrome is noted to have a large right-sided pleural effusion and a small to medium-sized left-sided pleural effusion. What would explain this finding?
a. The nephrosis is complicated by CHF.
b. The nephrosis is complicated by pulmo-nary emboli.
c. This is a common finding in patients with nephrosis.
d. This just a complicated case of nephrosis.
ANS: B
Patients with nephrosis are at increased risk of deep venous thrombosis and pulmonary emboli. In nephrosis, protein S, which keeps blood from clotting, becomes deficient from leaking into the urine. Therefore, the presence of large or asymmetric pleural effusions should raise the possibility of the presence of pulmonary emboli. Pleural effusions associated with pulmonary emboli usually are exudates and contain large numbers of red blood cells.
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