{"presentation":{"slides":[{"elements":[{"x":8.714596949891067,"y":6.479481641468682,"width":84.9673202614379,"height":34.557235421166304,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(229, 234, 242)","borderWidth":"1","borderStyle":"solid","borderColor":"rgb(0, 0, 0)","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"subContentId":"e3024312-fecb-45d1-8bc4-b372f1c8b6ca","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":8.714596949891067,"y":10.799136069114471,"width":83.87799564270152,"height":30.23758099352052,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

SUSPECT: <\/strong>
\nHistory: Any combination of - acute or chronic onset cough, chest pain, fever (low or high grade), shortness of breath, weight loss, loss of appetite, night sweats<\/p>\n\n

\nExamination:<\/strong> s\/o effusion - stony dull note on percussion, decreased breath sounds<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"ba80f973-84a3-410b-9918-76315363f1e7"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":8.714596949891067,"y":51.943844492440604,"width":84.9673202614379,"height":30.23758099352052,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"#fff","borderWidth":"1","borderStyle":"solid","borderColor":"rgb(0, 0, 0)","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"073f7b0a-2362-4044-874c-623589ca8262"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":9.803921568627452,"y":53.99568034557235,"width":83.87799564270152,"height":30.23758099352052,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Routine investigations:<\/strong> CBC, LFT, KFTs, PT\/INR (rule out contraindication to pleural tap) Radiography:
\n   Chest x-ray: <\/span><\/strong>For ALL cases even pregnant females with consent and abdominal shield
\n   Ultrasound:<\/strong><\/span> When available, use for guided pleurocentesis
\n   CT:<\/strong><\/span> Only if alternate diagnoses like malignancy strongly suspected<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"b31a931d-ad0e-4cad-bed2-48d032a03c3a"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":49.01960784313726,"y":43.196544276457885,"width":3.2679738562091503,"height":6.479481641468682,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6491f99a142a5.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"subContentId":"aa893b5c-df6b-45e5-acc3-0d54c705a8f9","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":9.803921568627452,"y":84.23326133909288,"width":82.78867102396515,"height":10.799136069114471,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Note :AFB, GeneXpert and MGIT liquid culture are not routinely recommended due to resource constraints and low sensitivity , however where available they can be considered<\/em><\/span><\/span><\/p>\n"},"subContentId":"55cf41b8-5c80-47db-8dce-24bcaa0067e7","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":5.446623093681917,"y":4.319654427645788,"width":40.30501089324619,"height":12.958963282937365,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"#fff","borderWidth":"1","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"subContentId":"f6332069-7990-43ee-a72d-6a5f2e192408","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":6.5359477124183005,"y":8.639308855291576,"width":39.97821350762527,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Pleural effusion diagnosed by radiologically<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"3bdcbf4e-b1b3-40bf-a6af-42c495f1644a"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":13.071895424836601,"y":19.43844492440605,"width":39.21568627450981,"height":17.278617710583152,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Rule out contraindications to tap \u2013<\/span><\/p>\n\n

Platelets <50,000\/uL | INR >2 | Consider correction if abnormal<\/span><\/p>\n"},"subContentId":"53897ce7-c911-4cce-baa4-9eaf44afc70f","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":5.446623093681917,"y":38.8768898488121,"width":22.875816993464053,"height":12.958963282937365,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"#fff","borderWidth":"1","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"5e39f230-e6e8-4c23-9f00-30e222c8aa35"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":6.5359477124183005,"y":43.196544276457885,"width":22.875816993464053,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Diagnostic pleural tap* <\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"edb55a10-7c59-4ad6-ab1c-82592a0d2ec4"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":4.357298474945534,"y":51.83585313174946,"width":7.625272331154684,"height":15.11879049676026,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6491feea49f9f.png","mime":"image\/png","copyright":{"license":"U"},"width":512,"height":512}},"metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"be86bae1-bd51-4e97-b89a-a0152f459c4a"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":5.446623093681917,"y":67.09265658747302,"width":55.55555555555556,"height":31.533477321814257,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"#fff","borderWidth":"1","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"e6773e51-7b4c-4803-bdd5-32160434243b"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":6.535947712418301,"y":69.2585313174946,"width":55.55555555555556,"height":25.91792656587473,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

For ALL patients:<\/strong>
\nPleural fluid \u2013 total counts, differential cell count, glucose, protein, ADA, cytology<\/p>\n\n

For clinically suspected cases: <\/strong>
\nBacterial and fungal cultures maybe sent as well<\/p>\n\n

<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"00de36a1-ae6c-4344-82c8-05c650c5ff8e"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":63.18082788671024,"y":6.479481641468682,"width":30.065359477124183,"height":53.99568034557235,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6492002c8d509.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":403,"height":367}},"subContentId":"26e7ae4c-69f7-465c-8be2-aec9ac0471df","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":63.18082788671024,"y":69.11447084233261,"width":30.501089324618736,"height":23.758099352051836,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Note :AFB, GeneXpert and MGIT liquid culture are not routinely recommended due to resource constraints and low sensitivity , however where available they can be considered<\/em><\/span><\/span><\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"1626300a-cf1c-4018-aa11-9b70269b5428"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":4.357298474945534,"y":19.43844492440605,"width":7.625272331154684,"height":15.11879049676026,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6491feea49f9f.png","mime":"image\/png","copyright":{"license":"U"},"width":512,"height":512}},"metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"4fb0ce73-0839-4942-825f-3e28bc98a34c"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":4.357298474945534,"y":2.159827213822894,"width":88.99782135076254,"height":97.19222462203024,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6492011f92f99.png","mime":"image\/png","copyright":{"license":"U"},"width":1995,"height":1105}},"subContentId":"a277a21d-630b-4aca-863e-49ca10c0f453","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":5.446623093681917,"y":6.479481641468682,"width":28.32244008714597,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Pleural Fluid Examination <\/strong><\/span><\/p>\n"},"subContentId":"7cd6dc35-2e08-490d-8310-86f7461602a1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":4.357298474945534,"y":17.314622030237583,"width":44.66230936819172,"height":79.91360691144709,"action":{"library":"H5P.Table 1.1","params":{"text":"

\n\n\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\t\n\t\t\t\n\t\t\t\n\t\t\t\n\t\t\t
Pleural Fluid<\/strong><\/td>\n\t\t\t Frequency<\/strong><\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t
Exudate with protein >3g\/dL<\/div>\n\n\t\t\t
<\/div>\n\t\t\t<\/td>\n\t\t\t
Almost all [1] <\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t
Pleural fluid glucose >60 mg\/dL# <\/div>\n\n\t\t\t
<\/div>\n\t\t\t<\/td>\n\t\t\t
80-85% [2]<\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t
>50% lymphocytes*<\/div>\n\n\t\t\t
<\/div>\n\t\t\t<\/td>\n\t\t\t
93.3% [2] <\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t
Pleural fluid ADA >40 IU\/L<\/div>\n\n\t\t\t
<\/div>\n\t\t\t<\/td>\n\t\t\t
81-100% [3] <\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t
Pleural fluid culture positivity<\/div>\n\n\t\t\t
<\/div>\n\t\t\t<\/td>\n\t\t\t
12-70% [4]<\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t
Pleural fluid GeneXpert MTB\/Rif (vs culture)<\/div>\n\n\t\t\t
<\/div>\n\t\t\t<\/td>\n\t\t\t
46.4% [5] <\/td>\n\t\t<\/tr>\n\t<\/tbody>\n<\/table>\n\n
<\/div>\n<\/div>\n"},"subContentId":"db2f9798-5e66-43eb-84ad-94c697fec1df","metadata":{"contentType":"Table","license":"U","title":"Untitled Table"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":50.10893246187364,"y":43.196544276457885,"width":47.930283224400874,"height":53.99568034557235,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
1. Light RW, Lee YCG, editors. Effusions from infections: Tuberculosis. In: Textbook of Pleural Diseases. 3 edition. Boca Raton: CRC Press; 2016
\n2. Vald\u00e9s L et al. Tuberculous pleurisy: a study of 254 patients. Arch Intern Med. 1998 Oct 12;158(18):2017-21
\n3. Mac\u00edas A et al Epidemiology and diagnosis of pleural tuberculosis in a low incidence country with high rate of immigrant population: A retrospective study. Int J Infect Dis. 2019 Jan;78:34-38
\n4. Gopi A et al Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest. 2007 Mar;131(3):880-889
\n5. Denkinger CM et al Xpert MTB\/RIF assay for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis. Eur Respir J. 2014 Aug;44(2):435-46<\/span><\/p>\n"},"subContentId":"4088ad50-0182-4f31-800c-1ddbcca935b8","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":53.37690631808278,"y":19.546436285097194,"width":40.08714596949891,"height":21.598272138228943,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"#fff","borderWidth":"1","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"2db5d73f-2564-418f-83cd-21abe7e4598f"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":54.46623093681917,"y":23.806047516198703,"width":38.12636165577342,"height":15.11879049676026,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
#: Lower values with chronic effusion\/empyema[1]
\n*: Early in the course, neutrophils may predominate<\/span><\/span>
\n <\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"f2af4c0b-b796-44ae-a7e7-ae51e066c850"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}}],"keywordListEnabled":true,"globalBackgroundSelector":{},"keywordListAlwaysShow":false,"keywordListAutoHide":false,"keywordListOpacity":90},"override":{"activeSurface":false,"hideSummarySlide":false,"summarySlideSolutionButton":true,"summarySlideRetryButton":true,"enablePrintButton":false,"social":{"showFacebookShare":false,"facebookShare":{"url":"@currentpageurl","quote":"I scored @score out of @maxScore on a task at @currentpageurl."},"showTwitterShare":false,"twitterShare":{"statement":"I scored @score out of @maxScore on a task at @currentpageurl.","url":"@currentpageurl","hashtags":"h5p, course"},"showGoogleShare":false,"googleShareUrl":"@currentpageurl"}},"l10n":{"slide":"Slide","score":"Score","yourScore":"Your Score","maxScore":"Max Score","total":"Total","totalScore":"Total Score","showSolutions":"Show solutions","retry":"Retry","exportAnswers":"Export text","hideKeywords":"Hide sidebar navigation menu","showKeywords":"Show sidebar navigation menu","fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen","prevSlide":"Previous slide","nextSlide":"Next slide","currentSlide":"Current slide","lastSlide":"Last slide","solutionModeTitle":"Exit solution mode","solutionModeText":"Solution Mode","summaryMultipleTaskText":"Multiple tasks","scoreMessage":"You achieved:","shareFacebook":"Share on Facebook","shareTwitter":"Share on Twitter","shareGoogle":"Share on Google+","summary":"Summary","solutionsButtonTitle":"Show comments","printTitle":"Print","printIngress":"How would you like to print this presentation?","printAllSlides":"Print all slides","printCurrentSlide":"Print current slide","noTitle":"No title","accessibilitySlideNavigationExplanation":"Use left and right arrow to change slide in that direction whenever canvas is selected.","accessibilityCanvasLabel":"Presentation canvas. Use left and right arrow to move between slides.","accessibilityProgressBarLabel":"Choose slide to display","containsNotCompleted":"@slideName contains not completed interaction","containsCompleted":"@slideName contains completed interaction","slideCount":"Slide @index of @total","containsOnlyCorrect":"@slideName only has correct answers","containsIncorrectAnswers":"@slideName has incorrect answers","shareResult":"Share Result","accessibilityTotalScore":"You got @score of @maxScore points in total","accessibilityEnteredFullscreen":"Entered fullscreen","accessibilityExitedFullscreen":"Exited fullscreen","confirmDialogHeader":"Submit your answers","confirmDialogText":"This will submit your results, do you want to continue?","confirmDialogConfirmText":"Submit and see results","slideshowNavigationLabel":"Slideshow navigation"}}

Pleural Fluid<\/strong><\/td>\n\t\t\t	Frequency<\/strong><\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t Exudate with protein >3g\/dL<\/div>\n\n\t\t\t <\/div>\n\t\t\t<\/td>\n\t\t\t	Almost all [1] <\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t Pleural fluid glucose >60 mg\/dL# <\/div>\n\n\t\t\t <\/div>\n\t\t\t<\/td>\n\t\t\t	80-85% [2]<\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t >50% lymphocytes*<\/div>\n\n\t\t\t <\/div>\n\t\t\t<\/td>\n\t\t\t	93.3% [2] <\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t Pleural fluid ADA >40 IU\/L<\/div>\n\n\t\t\t <\/div>\n\t\t\t<\/td>\n\t\t\t	81-100% [3] <\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t Pleural fluid culture positivity<\/div>\n\n\t\t\t <\/div>\n\t\t\t<\/td>\n\t\t\t	12-70% [4]<\/td>\n\t\t<\/tr>\n\t\t
\n\t\t\t Pleural fluid GeneXpert MTB\/Rif (vs culture)<\/div>\n\n\t\t\t <\/div>\n\t\t\t<\/td>\n\t\t\t	46.4% [5] <\/td>\n\t\t<\/tr>\n\t<\/tbody>\n<\/table>\n\n <\/div>\n<\/div>\n"},"subContentId":"db2f9798-5e66-43eb-84ad-94c697fec1df","metadata":{"contentType":"Table","license":"U","title":"Untitled Table"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":50.10893246187364,"y":43.196544276457885,"width":47.930283224400874,"height":53.99568034557235,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":" 1. Light RW, Lee YCG, editors. Effusions from infections: Tuberculosis. In: Textbook of Pleural Diseases. 3 edition. Boca Raton: CRC Press; 2016 \n2. Vald\u00e9s L et al. Tuberculous pleurisy: a study of 254 patients. Arch Intern Med. 1998 Oct 12;158(18):2017-21 \n3. Mac\u00edas A et al Epidemiology and diagnosis of pleural tuberculosis in a low incidence country with high rate of immigrant population: A retrospective study. Int J Infect Dis. 2019 Jan;78:34-38 \n4. Gopi A et al Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest. 2007 Mar;131(3):880-889 \n5. Denkinger CM et al Xpert MTB\/RIF assay for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis. Eur Respir J. 2014 Aug;44(2):435-46<\/span><\/p>\n"},"subContentId":"4088ad50-0182-4f31-800c-1ddbcca935b8","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":53.37690631808278,"y":19.546436285097194,"width":40.08714596949891,"height":21.598272138228943,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"#fff","borderWidth":"1","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"2db5d73f-2564-418f-83cd-21abe7e4598f"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":54.46623093681917,"y":23.806047516198703,"width":38.12636165577342,"height":15.11879049676026,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":" #: Lower values with chronic effusion\/empyema[1] \n*: Early in the course, neutrophils may predominate<\/span><\/span> \n <\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"f2af4c0b-b796-44ae-a7e7-ae51e066c850"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}}],"keywordListEnabled":true,"globalBackgroundSelector":{},"keywordListAlwaysShow":false,"keywordListAutoHide":false,"keywordListOpacity":90},"override":{"activeSurface":false,"hideSummarySlide":false,"summarySlideSolutionButton":true,"summarySlideRetryButton":true,"enablePrintButton":false,"social":{"showFacebookShare":false,"facebookShare":{"url":"@currentpageurl","quote":"I scored @score out of @maxScore on a task at @currentpageurl."},"showTwitterShare":false,"twitterShare":{"statement":"I scored @score out of @maxScore on a task at @currentpageurl.","url":"@currentpageurl","hashtags":"h5p, course"},"showGoogleShare":false,"googleShareUrl":"@currentpageurl"}},"l10n":{"slide":"Slide","score":"Score","yourScore":"Your Score","maxScore":"Max Score","total":"Total","totalScore":"Total Score","showSolutions":"Show solutions","retry":"Retry","exportAnswers":"Export text","hideKeywords":"Hide sidebar navigation menu","showKeywords":"Show sidebar navigation menu","fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen","prevSlide":"Previous slide","nextSlide":"Next slide","currentSlide":"Current slide","lastSlide":"Last slide","solutionModeTitle":"Exit solution mode","solutionModeText":"Solution Mode","summaryMultipleTaskText":"Multiple tasks","scoreMessage":"You achieved:","shareFacebook":"Share on Facebook","shareTwitter":"Share on Twitter","shareGoogle":"Share on Google+","summary":"Summary","solutionsButtonTitle":"Show comments","printTitle":"Print","printIngress":"How would you like to print this presentation?","printAllSlides":"Print all slides","printCurrentSlide":"Print current slide","noTitle":"No title","accessibilitySlideNavigationExplanation":"Use left and right arrow to change slide in that direction whenever canvas is selected.","accessibilityCanvasLabel":"Presentation canvas. 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Diagnosis of Pleural TB

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Diagnosis of Pleural TB

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