A patient presents to the emergency department with dyspnea, diminished breath sounds on the right side, and a chest x-ray confirming a large right-sided pleural effusion. Which procedure is most indicated for both therapeutic relief of symptoms and diagnostic analysis of the fluid?
Bronchoscopy
Chest tube placement
Needle decompression
Thoracentesis
The correct answer is thoracentesis. Thoracentesis is a procedure used to remove fluid from the pleural space for both diagnostic and therapeutic purposes. In a patient with a large pleural effusion causing respiratory symptoms, thoracentesis can provide immediate relief by draining the fluid and reducing pressure on the lung. The collected fluid can then be analyzed to determine the underlying cause of the effusion. Chest tube placement is typically reserved for longer-term drainage, such as for a hemothorax or empyema. Needle decompression is the emergent treatment for a tension pneumothorax, not a pleural effusion. Bronchoscopy is an endoscopic technique used to visualize the inside of the airways and is not used to drain pleural fluid.
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