Pleural Effusion, Empyema and Pneumothorax in Children: Board Questions

What this deck covers

Pleural Effusion, Empyema and Pneumothorax in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Strands and pockets on the scan
2. Which scan to ask for
3. A little fluid, getting better
4. The drain that will not drain
5. When the drain has had its chance
6. What came out of the needle
7. Will his lung recover
8. Sudden pain in front of the television
9. A thin rim and a comfortable patient
10. Deviated trachea in the changing room
11. The same air in a worse lung
12. The third time this year
13. Milky fluid in the bottle
14. A torch on the chest wall
15. The holiday he has booked
16. It stopped swinging overnight
17. Time to take the tube out
18. Which one gets a drain today

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: An organising empyema, Magnetic resonance imaging, Instil a fibrinolytic agent through the drain, A transudate, A primary spontaneous pneumothorax.

Clinical pearls from this deck

• Strands and pockets on ultrasound decide the treatment before the drain is even chosen.
• Ultrasound at the bedside, not a scan down the corridor. It answers more and costs less.
• Treat the child, not the picture. An improving child with a small rim needs nothing done.
• Confirm the position first. Then a drain that will not drain is telling you about the fluid.
• Drain, then fibrinolytic, then theatre. Skipping a step or lingering on one both cost days.
• If it looks like pus, it is pus. Drain it and let the laboratory catch up afterwards.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Respiratory Board Questions case decks · pediatric reference values.