American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which therapy is suggested for patients with large volume chest fluid accumulation?

1. Fluid replacement therapy

2. Chest tube insertion

3. Antibiotic therapy

4. Surgical thoracotomy

The correct answer is: Chest tube insertion

The suggested therapy for patients with large volume chest fluid accumulation is chest tube insertion. This procedure is pivotal in managing pleural effusions or collections of fluid in the pleural space, which can lead to respiratory distress and decreased lung function if not addressed properly. Chest tube insertion allows for the effective drainage of fluid, which not only alleviates symptoms of dyspnea but also facilitates the expansion of the lung back to its normal position in the thoracic cavity. It is typically performed under local anesthesia and can be done at the bedside. This approach is often preferred due to its minimally invasive nature and the ability to repeat the procedure if necessary. Other therapies, such as fluid replacement therapy, are not indicated in cases of fluid accumulation in the chest as they could exacerbate the problem. Antibiotic therapy may be indicated if an infectious process is identified, but it does not directly address the fluid accumulation. Surgical thoracotomy is more invasive and generally reserved for specific cases where there are other complications or when drainage via a chest tube is insufficient. Thus, chest tube insertion is the most appropriate initial intervention for managing large volume chest fluid accumulation.