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Related Concept Videos

Pleural Effusion I: Introduction01:25

Pleural Effusion I: Introduction

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Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
615
Pleural Effusion II: Symptoms and Management01:28

Pleural Effusion II: Symptoms and Management

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Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
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Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Pneumothorax-II01:27

Pneumothorax-II

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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Pleural Disorders: Types and Brief Description01:30

Pleural Disorders: Types and Brief Description

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The pleura is a vital part of the respiratory system. It's a double-layered membrane surrounding the lungs and lining the chest cavity. The two layers of the pleura are:
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Rheumatoid arthritis associated recurrent pleural effusion.

Ramsha Abbas1, Muhammad Ahmed Khan1, Anthony El Khoury2

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Rheumatoid arthritis (RA) can present with rare pleural effusions and lung nodules, even without joint symptoms. This case highlights the need for advanced treatments for persistent RA-related pleural effusions.

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Area of Science:

  • Rheumatology
  • Pulmonology
  • Pathology

Background:

  • Rheumatoid arthritis (RA) is a systemic autoimmune disease primarily affecting joints.
  • Extra-articular manifestations, including pleural effusions and pulmonary nodules, can occur in RA.
  • Pleural involvement without overt arthritis is an uncommon presentation.

Observation:

  • A 66-year-old male presented with dyspnea and weight loss.
  • Imaging revealed bilateral pleural effusions and pulmonary nodules.
  • Thoracoscopic biopsy showed chronic pleuritis and granulomatous inflammation.

Findings:

  • The patient was diagnosed with rheumatoid arthritis based on subsequent joint stiffness and positive rheumatoid markers.
  • Treatment with prednisone and methotrexate provided initial symptomatic relief.
  • Recurrent pleural effusions necessitated repeated thoracenteses despite treatment.

Implications:

  • This case underscores that rheumatoid arthritis can manifest with significant pleural disease and lung nodules in the absence of clinically apparent arthritis.
  • Advanced treatment strategies may be required for managing persistent or recurrent pleural effusions in RA patients.
  • Early recognition of RA as a cause of unexplained pleural effusions and lung nodules is crucial for appropriate patient management.