[94] Pleural Effusion Flashcards
What is a pleural effusion?
An abnormal collection of fluid in the pleural space
Are pleural effusions primary or secondary?
It can be a primary manifestation, or a secondary complication of many disorders
What do pleural effusions usually occur as a result of?
Complications of other conditions
What are the most common conditions causing pleural effusions?
- Pneumonia or other infections
- Congestive heart failure
- Chest surgery
- Autoimmune conditions, e.g. Lupus
What does the presentation of pleural effusion depend on?
- Underlying disease
- Size and location of the effusion
What do children with an effusion as a complication of pneumonia often have a history of
Recent URTI
How might children with a pleural effusion as a result of pneumonia present?
- Persistent fever
- Cough
- Anorexia and malaise
- Tachypnoea
- Chest pain
How are children with tuberculous pleural effusions more likely to present?
With a Tb-like picture (obviously)
How do malignant pleural effusions present?
May be more indolent, and cause either no symptoms, or only cough and low-grade fever
Give two examples of causes of transudative pleural effusions
- Congestive heart failure
- Nephrotic syndrome
What determines the presenting symptoms in transudative pleural effusion?
The underlying disease
What may be found on examination in pleural effusions?
- Dyspnoea
- Anxiety (due to pain, discomfort, or hypoxaemia)
- Pleural rub
- Fullness of intercostal spaces and diminished chest expansion on affected side
What investigations should be done in pleural effusions?
- CXR
- Pleural fluid analysis
- Tests to determine cause
What are the differential diagnoses for pleural effusions?
- Atelectasis
- Lung abscess
- Simple pneumonia
What is the purpose of treatment for pleural effusion?
Usually aimed at treatment of the effusion itself and the condition that originally caused it
