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
Do small pleural effusions require treatment?
May not
When will a pleural effusion require treatment?
If it is causing symptoms
How are pleural effusions usually treated?
Chest drain
What should be done if there are repeated pleural effusions?
Video-assisted thoracoscopic surgery
