This document provides information on pleural diseases from the Department of Pulmonary Medicine. It discusses the anatomy and physiology of the pleura, and then summarizes different pleural conditions including pneumothorax, pleural effusion, and empyema. For each condition, it outlines the epidemiology, etiology, clinical features, investigations, and treatment. The document uses headings to separate each section and provides detailed information on evaluating and managing common pleural diseases.
there is the introduction part of the torso trauma,
check out my next ppts for further more about torso trauma.
contents are in following order...
introduction
mechanism of injury
junctional zones of torso
tension pneumothorax
cardiac temponade
massive hemothorax
etc.
check out all slides
Pulmonary Oedema is accumulation of fluid in lungs. It can be due to cardiogenic or non-cardiogenic causes. This presentation was a class presentation and discussed its management alongwith diagnosis.
Bronchiectasis
A condition characterized by chronic permanent dilation & destruction of bronchi due to destructive changes in the elastic and muscular layers of bronchial walls.
The common thread in the pathogenesis of bronchiectasis consists of difficulty clearing secretions & recurrent infections with a “vicious circle” of infection and inflammation resulting in airway injury and remodelling.
PLEASE REFER TO REFERENCE TEXTBOOKS FOR CLARITY.
there is the introduction part of the torso trauma,
check out my next ppts for further more about torso trauma.
contents are in following order...
introduction
mechanism of injury
junctional zones of torso
tension pneumothorax
cardiac temponade
massive hemothorax
etc.
check out all slides
Pulmonary Oedema is accumulation of fluid in lungs. It can be due to cardiogenic or non-cardiogenic causes. This presentation was a class presentation and discussed its management alongwith diagnosis.
Bronchiectasis
A condition characterized by chronic permanent dilation & destruction of bronchi due to destructive changes in the elastic and muscular layers of bronchial walls.
The common thread in the pathogenesis of bronchiectasis consists of difficulty clearing secretions & recurrent infections with a “vicious circle” of infection and inflammation resulting in airway injury and remodelling.
PLEASE REFER TO REFERENCE TEXTBOOKS FOR CLARITY.
the lecture approaches the problem of solitary pulmonary nodule in terms of variable imaging findings,differential diagnosis and algorithm of follow up .
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
Pleural disease
1. Department of Pulmonary Medicine
PLEURAL DISEASES
Dr. Rahul Magazine
M.D. (Medicine), D.T.C.D.
Department of Pulmonary Medicine
2. ANATOMY
• The pleura is the serous membrane that
covers the lung parenchyma (visceral
pleura) , the mediastinum, the diaphragm,
and the rib cage (parietal pleura).
• visceral pleura: blood supply from low-
pressure pulmonary circulation, and has
no sensory nerves
• parietal pleura: from the systemic
circulation and contains sensory nerves
Department of Pulmonary Medicine
3. PHYSIOLOGY
The two layers of the pleura are separated
by a virtual cavity, which is lubricated by 5 to
10 mL of fluid, facilitates lung expansion,
and helps maintain lung inflation by coupling
the lungs with the chest wall.
Department of Pulmonary Medicine
5. CLASSIFICATION
1. Spontaneous
Primary (e.g. rupture of pleural bleb)
Secondary (e.g.TB, COPD)
2. Traumatic
Iatrogenic (e.g. following thoracic surgery/biopsy)
Non-iatrogenic
Department of Pulmonary Medicine
6. CLINICAL FEATURES
Symptoms:
Sudden-onset unilateral chest pain ranging
from minimal to severe on the affected side.
Dyspnea occur in nearly all patients.
May present with life-threatening respiratory
failure if underlying diseased lung
Department of Pulmonary Medicine
7. Signs:
If pneumothorax is small: (< 15% of a
hemithorax), physical findings are unimpressive.
If pneumothorax is large: signs of mediastinal
shift to opposite side, ↓ed movement, ↓ed tactile
fremitus and diminished breath sounds Tension
pneumothorax should be suspected in the
presence of marked tachycardia and
hypotension.
Department of Pulmonary Medicine
8. INVESTIGATION
• Chest X-ray shows the sharply defined
edge of the deflated lung with complete
translucency (no lung markings) between
this and the chest wall
• CT Thorax if in doubt
• Investigations aimed at finding the cause
(e.g. Pulmonary TB, COPD)
Department of Pulmonary Medicine
9. PRIMARY SPONTANEOUS
PNEUMOTHORAX
Incidence and Patient Demographics:
– 7.4/100,000/year for males and
1.2/100,000/year for females.
– The male-to-female predominance ranges from
6-to-1 to 3-to-1.
– 20 and 40 years of age
– taller and thinner
– Occurs almost exclusively in smokers
Department of Pulmonary Medicine
10. Etiology:
• Rupture of subpleural blebs or bullae on the
apical portion of the upper lobes
• Airway inflammation secondary to cigarette
smoking may contribute to the development
of these blebs
• Other etiologies include abnormalities of
connective tissue (e.g.,Marfan’s syndrome)
• Genetic risk factors
Department of Pulmonary Medicine
11. Recurrence:
• Approximately one-half of patients
• Usually occurs within 1 to 2 years after the
first episode.
• No predilection for the right or left
hemithorax with the initial episode, 75
percent of recurrences occur on the same
side as the first pneumothorax.
Department of Pulmonary Medicine
12. Treatment:
• Simple aspiration
• If the lung does not expand with
aspiration, or if the patient has a recurrent
pneumothorax, thoracoscopy with stapling
of blebs and pleural abrasion is indicated.
Thoracoscopy or thoracotomy with pleural
abrasion is almost 100% successful in
preventing recurrences.
Department of Pulmonary Medicine
14. Secondary Spontaneous
Pneumothorax
Incidence and Patient Demographics:
• 6.3/100,000/year for males and
2.0/100,000/year for females
• Patients with secondary spontaneous
pneumothorax are 15 to 20 years older than
patients with primary spontaneous
pneumothorax.
• The risks of recurrence vary from 40 to 80 %
Department of Pulmonary Medicine
15. Etiology:
• Obstructive lung disease
Chronic obstructive lung disease (COPD)
Asthma
• Interstitial lung disease
Idiopathic pulmonary fibrosis
Eosinophillic granuloma
Lymphangioleiomyomatosis
Department of Pulmonary Medicine
16. • Infection
Tuberculosis
P. jerovici pneumonia
Acute bacterial pneumonia (i.e.
staphylococcus)
• Malignancy
Primary lung carcinoma
Pulmonary metastasis (especially
sarcomas)Department of Pulmonary Medicine
17. • Connective tissue disease
Rheumatoid arthritis
Ankylosing spondylitis
• Other
Catamenial pneumothorax
Pulmonary infarction
Department of Pulmonary Medicine
18. Treatment:
• Nearly all patients treated with tube
thoracostomy.
• Most should also be treated with
thoracoscopy or thoracotomy with the stapling
of blebs and pleural abrasion.
• If the patient not a good operative candidate
or refuses surgery, then pleurodesis to be
done by intrapleural injection of sclerosing
agent such as doxycycline.
Department of Pulmonary Medicine
19. Prognosis:
In contrast to the low mortality rate in PSP,
in patients with SSP, there is a much higher
risk of mortality.
Department of Pulmonary Medicine
20. Traumatic Pneumothorax
Department of Pulmonary Medicine
• Trauma is the most common cause of
pneumothorax
• Both penetrating and nonpenetrating chest
trauma
• Treatment is tube thoracostomy unless very
small. If hemopneumothorax is present, one
chest tube placed in the superior part of the
hemithorax to evacuate air, and another
placed in the inferior part of the hemithorax to
remove blood.
21. COMPLICATIONS
TENSION PNEUMOTHORAX
• Is a pneumothorax in which the pressure
in the pleural space is positive throughout
the respiratory cycle.
• The mechanism responsible for tension
pneumothorax is the disruption of the
visceral or parietal pleura in such a
manner that a one-way valve develops.
Department of Pulmonary Medicine
22. • A tension pneumothorax can occur after any
type of pneumothorax; it is independent of the
etiology. It can sometimes occur after a
spontaneous pneumothorax but is more
common after a traumatic pneumothorax,
with mechanical ventilation, or during
cardiopulmonary resuscitation.
Department of Pulmonary Medicine
23. • Clinical picture:
The patient will appear acutely ill
Severe dyspnea, Profuse diaphoresis
Cyanosis
On physical examination:
Profound hypotension and hypoxemia
Distended neck veins
Tracheal deviations to the side opposite,
Subcutaneous emphysema
Unilateral chest hyperinflation.
Department of Pulmonary Medicine
24. • If the tension in the pleural space is not
relieved, the patient is likely to die from
inadequate cardiac output or marked
hypoxemia.
• A large-bore needle should be inserted into
the pleural space through the second anterior
intercostal space. If large amounts of gas
escape from the needle, the diagnosis is
confirmed. The needle should be left in place
until a thoracostomy tube can be inserted.
Department of Pulmonary Medicine
25. Re-expansion Pulmonary Edema:
• Re-expansion pulmonary edema is a rare
but potentially lethal condition that can
occur with the rapid reexpansion of a
collapsed lung (after a varied period of
time) after tube thoracostomy is used to
drain air (pneumothorax) or fluid (pleural
effusion) from the pleural space.
Bronchopleural Fistula
Department of Pulmonary Medicine
32. MECHANISMS OF PLEURAL FLUID
ACCUMULATION
• Increased hydrostatic pressure in the microvascular
circulation (heart failure)
• Decreased oncotic pressure in the microvascular
circulation (severe hypoalbuminemia)
• Decreased pressure in the pleural space (lung
collapse)
• Increased permeability of the microvascular
circulation (pneumonia)
• Impaired lymphatic drainage from the pleural space
(malignant effusion)
• Movement of fluid from the peritoneal space (ascites)
Department of Pulmonary Medicine
33. ETIOLOGY
Transudative Pleural Effusions
• Congestive heart failure
• Cirrhosis
• Peritoneal dialysis
• Nephrotic syndrome
• Superior vena cava obstruction
• Myxedema
• Pulmonary thromboemboli
Department of Pulmonary Medicine
35. • Drug-induced pleural disease
Nitrofurantoin, Amiodarone
• Asbestos exposure
• Chylothorax
• Hemothorax
• Postsurgical
• Sarcoidosis
• Uremic pleuritis
• Yellow nail syndrome
Department of Pulmonary Medicine
36. CLINICAL FEATURES
Symptoms
Many patients have no symptoms referable to
the effusion.
Pleuritic chest pain indicates inflammation of
the pleura
• Some patients with pleural effusions experience
a dull, aching chest pain rather than pleuritic
chest pain. This symptom is very suggestive that
the patient has pleural malignancy.
Department of Pulmonary Medicine
37. • The presence of either pleuritic chest pain or dull,
aching chest pain indicates that the parietal pleura
is probably involved and that the patient has an
exudative pleural effusion.
Dry, nonproductive cough. It may be related to
pleural inflammation. or lung compression by
the fluid may bring opposing bronchial walls
into contact, stimulating the cough reflex.
Department of Pulmonary Medicine
38. Dyspnea. A pleural effusion acts as a space-
occupying process in the thoracic cavity and
therefore reduces all subdivisions of lung
volumes.
Department of Pulmonary Medicine
39. Signs
• Hemithorax will be larger, and the usual
concavity of the intercostal spaces will be
blunted or even convex
• Tactile fremitus is absent or attenuated
because the fluid absorbs the vibrations
emanating from the lung.
• Medisatinal Shift (Tracheal and apical
impulse shift to opposite side)
Department of Pulmonary Medicine
40. • Percussion note is dull
• Shifting dullness (free fluid)
• Auscultation: reveals decreased or absent
breath sounds. Sometimes pleural rub
Department of Pulmonary Medicine
41. Clues to the origin are often present elsewhere.
• Cardiomegaly, neck vein distension, or
peripheral edema(CHF).
• Signs of joint disease or subcutaneous
nodules (rheumatoid disease or lupus
erythematosus).
• An enlarged, nontender nodular liver or the
presence of hypertrophic osteoarthropathy
suggests metastatic disease, as do breast
masses or the absence of a breast.
Department of Pulmonary Medicine
42. • Abdominal tenderness suggests a
subdiaphragmatic process, whereas tense
ascites suggests cirrhosis
• Lymphadenopathy suggests lymphoma,
metastatic disease, or sarcoidosis.
Department of Pulmonary Medicine
43. INVESTIGATIONS
Chest X-ray:
Blunting of the sharp costophrenic angle.
Fluid accumulation between the lung and the
diaphragm (subpulmonic effusion) is
suspected if there is apparent elevation of the
hemidiaphragm or widening of the shadow
between the gas-containing stomach and the
lower left lung margin.
Department of Pulmonary Medicine
44. Chest X-ray:
Up to 300 mL of fluid may fail to be seen on a PA
chest radiograph, whereas as little as 150 mL may
be seen on a lateral decubitus view.
A supine film (e.g. in ICU patients) may obscure the
diagnosis because the fluid layers posteriorly.
A pseudotumor occurs when fluid loculates in an
interlobar fissure, a clue to the diagnosis is the
presence of pleural fluid elsewhere and a biconvex
lenticular configuration of the mass.
Department of Pulmonary Medicine
45. • USG
• CT Thorax
• Pleural aspiration
Department of Pulmonary Medicine
49. PLEURAL EFFUSION.: A, Blood-stained pleural aspirate. This patient
had pleural metastases from carcinoma of the breast.
B, Chylous pleural effusion. This patient had bronchial carcinoma that
had invaded and obstructed the thoracic duct.
C, Pleural transudate. This pale effusion is typically found in patients
with heart failure or other causes of generalized edema.
Department of Pulmonary Medicine
52. EMPYEMA
• Is pus in the pleural space
Etiology:
• Empyema is always secondary to infection
in a neighbouring structure, usually the
lung. The principal infections liable to
produce empyema are the bacterial
pneumonias and TB.
Department of Pulmonary Medicine
54. Clinical Features
Symptoms:
• Pyrexia, usually high and remittent
• Rigors, sweating, malaise and weight loss
• Pleural pain
• Breathlessness
• Cough and sputum usually because of
underlying lung disease;
• Copious purulent sputum (bronchopleural
fistula)
Department of Pulmonary Medicine
55. Signs:
• Clinical signs of fluid in the pleural space
• Intercostal tenderness
Department of Pulmonary Medicine
56. Treatment
• Antibiotics OR anti tubercular drugs
• Intercostal tube drainage
• Decortication if gross thickening of the
visceral pleura has developed and is
preventing re-expansion of the lung
Department of Pulmonary Medicine