Q: All of the following cab be used to establish tuberculous pericarditis except? 

A) acid-fast smear/culture 
B) adenosine deaminase concentration 
C) pericardial biopsy 
D) right scalene lymph node biopsy (if lymphadenopathy) 
E) transudative pericardial fluid


Answer: E

Tuberculous pericardial effusion is usually exudative and consist of high protein and increased leukocyte count, with a predominance of lymphocytes and monocytes. Essentially, Light's criteria for exudative pleural effusions can be equally applied for tuberculous pericardial effusion.


Reference: 

 Reuter H, Burgess L, van Vuuren W, Doubell A. Diagnosing tuberculous pericarditis. QJM 2006; 99:827.