Using binary questions with PLUS (pleural fluid yes/no, B lines yes/no etc.) ensures specific pathologies are considered and systematically ruled in or ruled out on the differential diagnostic list. This approach helps in keeping these exams standardized, as well as answering important clinical questions (hence why we do these exams). The binary question approach allows the clinician to expand their ultrasound skills as they become more comfortable with sonography and allows newer techniques to be incorporated without drastically changing the techniques used.