Pleural effusion / Internal medicine: Etiology, Clinical Features, Diagnosis, and Treatment
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- Опубликовано: 8 сен 2024
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Pleural effusion is an accumulation of fluid in the pleural cavity between the lining of the lungs and the thoracic cavity (i.e., the visceral and parietal pleurae). The pleural fluid is called a transudate if it permeates (transudes) into the pleural cavity through the walls of intact pulmonary vessels. It is called an exudate if it escapes (exudes) into the pleural cavity through lesions in blood and lymph vessels, e.g., as caused by inflammation and tumors. The accumulation of transudate is typically due to increased hydrostatic pressure (e.g., in congestive heart failure) and/or decreased oncotic pressure (e.g., in cirrhosis or nephrotic syndrome). Since transudate is a filtrate, it is typically a clear fluid with a low protein and cell content. By contrast, the lesions responsible for the outflow of exudate allow larger molecules and even solid matter to pass into the pleural cavity. For this reason, exudate is a cloudy fluid with a high protein and cell content. The effusion follows gravity and, unless the patient is bedridden, collects in the lower margins of the pleural cavity. Percussion over the area of effusion generates a dull tone, and breath sounds are diminished or completely absent on auscultation. Chest x-ray and ultrasound are usually performed as first-line tests to diagnose pleural effusion, but chest CT is sometimes required (e.g., for very small effusions). Thoracentesis with pleural fluid analysis is required to establish the underlying diagnosis in most pleural effusions and can also serve a therapeutic role. Treatment should focus on correcting the underlying condition.
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Big Thank You, highly academic
Thank you so much Sir for this awesome session 🙂🙏🏻
So nice of you
Great teacher in the world
Alwage best ❤️❤️❤️❤️❤️❤️🙏🙏🙏🙏🙏
If a large pleural effusion shows up on a chest x-ray, wouldn't additional tests be run as soon as possible, to see what is causing it?
More respiratory videos and physical Examination videos 👍
Sure
This is great
Magnifico 🤩🤩
Thank u so much
Great video! :D Thank you!
Our pleasure!
Healthy Well done Ma,am🙏
so good. thank you
Our pleasure!
Thanks Dr
Welcome
Thanks a lot sir...
Ur welcome
Thank you for help me dr.
🤝🤝🤝
Thank you Dr so useful vedio
🤝🤝🤝
10th of March this year i had symptoms of difficult in breathing together with severe sharp pains around my lungs regions.
I took chest xray and it showed i had pleural effusion more on my right lung. Doctors gave me antibiotics (AZUMA-Azithromycine) in which i took them for five days i started to feel well... and then I had my heart, kidney and liver examined and the results were just fine. So doctors thought my pleural effusion might have been caused by pneumonia so they gave me Ceftriaxone.
9th of April i took xray it showed very small amount of pleural effusion on my right lung. At this point I was recovering.
Then May 1st i started experiencing the same symptoms as of march, chest pains and heaviness, difficult in breathing, pains at my back.. All of it indicating pleural effusion.
6th of may this year the doctors started me the Anti-TB drugs, in which i am using them to this day more than a month and a week but my condition is still getting worse.
Need your help/advice
Please do a pleural fluid aspiration for biopsy and culture DST.
Biopsy to rule out malignancy, and culture to diagnose whether it's Tuberculosis. The DST will give you results of drug sensitivity to see whether you need first line drugs or second line. If it's TB, then mind you the treatment is going to be long and there could be many side effects such as change in body fluid color, peripheral neuropathy, hyperuracemia, color blindness etc. But with proper regimen the disease will be cured.
The reason I advised for the DST is that if you're on first line ATT, and it's been already one month and your symptoms have worsened instead, then the drugs might have not been effective. You might as well need second line treatment for DR TB. However, without a microbiological test it cannot be determined. Therefore do the tests and show it to your physician, or consult the physician and describe the problem again
Don't panic.
How are you now
Mam which softwere is used for this video . how amazing video result. Which resolation record.
Thanks sir,
Most welcome
Superb ❤
Is Every plural effusion treated with tb medicine???
I just got diagnosed with TB Pleural Effusion and prescribed TB medication for the next 6 months
@@winifrederoro i m taking that medicine since 3 month but right abdomen pain still like hell. Only fever resolved
@@Nainalkaur don't skip a day and continue to drink your doses daily. Trust me you will be healed once you fully complete your medication as prescribed. Well wishes 🙏
@@winifrederoro yea m taking medicines on daily basis.
Thanks
😍
Sir please reply and Any one who knows please reply.
Why cough in pleural effusion is dry cough?
Are u fine now
Is there an pdf of this lecture ?
Me watching this bc i have it.:
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This is what my friends Xray report says, she's 19, and thin, any views? IF anyone's reading this please explain me.
Report :
TITLE : XRAY - CHEST PA AND LAT VIEW
Moderate left pleural effusion is seen with collapse of underlying lung parenchyma, s/o infective etiology. (IN BOLD LETTERS)
Rest of the Lung fields are clear
Both hila are normal in size
The cardiac Shadow is normal