Air and Fluid in the Pleural Space

What this deck covers

Air and Fluid in the Pleural Space in twelve clinical teaching 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.

The 12 cases, in order

1. A little fluid at the base
2. Sudden pain in a tall thin boy
3. No time for a radiograph
4. Which way did it push?
5. Does it move?
6. Transudate or exudate
7. What the ultrasound adds
8. Watch, tap or drain
9. Above the rib, never below
10. The bottle stays on the floor
11. Reading the bubbles
12. When the fluid is milky

Diagnoses and management options tested

Across the twelve cases you are asked to choose between options such as: An empyema needing immediate drainage, Collapse of the left lower lobe, A small parapneumonic effusion, A small pneumothorax, A raised hemidiaphragm with crowded ribs, Computed tomography of the chest, Intubation and positive pressure ventilation first, Air bronchograms with a raised hemidiaphragm, Proceed directly to thoracotomy and decortication, Empyema; intravenous antibiotics and a fibrinolytic, Haemothorax; transfusion and surgical exploration.

Clinical pearls from this deck

• Fluid falls and air rises. A blunted costophrenic angle beside a pneumonia is a small parapneumonic effusion until it behaves otherwise.
• The diagnosis is the visceral pleural line with no lung markings beyond it. A tall thin adolescent with sudden pleuritic pain is the classic primary spontaneous pneumothorax.

The twelve worked cases in this deck, with the images and the full explanation of every option, are part of Pediatric Case Review membership. See what is included.

More from this system: all respiratory decks and question sets · pediatric reference values.