This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Respiratory system, Subject name: Medicine
Pleural effusion with very low glucose is 
Select and explain. 
A. Malignancy, B. Tuberculosis, C. SLE, D. Rheumatoid ahritis
D: Rheumatoid ahritis
Answer: D: Rheumatoid ahritis 
Explanation: Rheumatoid ahritis produces an exudative pleural effusion with predominant lymphocytes,positive rheumatoid factor and anti-CCP antibodies,and very low glucose in pleural . Pleural involvement is the most frequent manifestation of rheumatoid ahritis (RA) in the chest. The effusion is an exudate and is characterized by low pH and glucose level, and high lactic dehydrogenase (LDH) and cell count low glucose also seen in malignancy,and tubercular effusion. Ref Davidson edition23rd pg 580