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Respiratory > 1(E): Pneumothorax > Flashcards

1(E): Pneumothorax Flashcards

1
Q

Define pneumothorax

A

Air with the pleural space

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2
Q

What is a primary pneumothorax

A

Pneumothorax with no underlying lung disease

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3
Q

What is a secondary pneumothorax

A

Pneumothorax with underlying lung disease

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4
Q

In which gender is primary pneumothorax more common

A

Male

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5
Q

Which age group is primary pneumothorax more common

A

20-30 years

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6
Q

Which age-group is secondary pneumothorax more common

A

60-70 years

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7
Q

What causes primary pneumothorax

A
  1. Connective Tissue Disease: Ehlers-Danlos, Marfans

2. Trauma

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8
Q

What causes secondary pneumothorax

A

Underlying lung disease:

  • COPD (emphysema)
  • Asthma
  • TB
  • Pneumonia
  • Carcinoma
  • CF
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9
Q

What can cause an iatrogenic pneumothorax

A
  • CVC line insertion
  • Pleural aspiration
  • Biopsy
  • Liver Biopsy
  • Mechanical ventilation
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10
Q

What is the stereotype for primary pneumothorax

A

Tall, thin male

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11
Q

What are 3 risk factors for primary pneumothorax

A
  • Tall, thin male
  • Smoking (20-times risk)
  • FH
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12
Q

Describe symptoms of pneumothorax

A

Sudden-onset:

  • Dyspneoa
  • Pleuritic chest pain
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13
Q

What are signs of pneumothorax on auscultation

A

Reduced breath sounds

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14
Q

What are signs of pneumothorax on percussion

A

Hyper-resonant to percussion

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15
Q

What is the main feature of a tension pneumothorax

A

Tracheal deviation

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16
Q

How may the chest appear in a tension pneumothorax

A

Reduced chest expansion (asymmetrical)

17
Q

What are symptoms of tension pneumothorax

A
  • Respiratory distress (cyanosis, hyperventilation)

- Haemodynamic compromised

18
Q

What is a mnemonic to remember features of pneumothorax

A

P-THORAX

19
Q

What are features of pneumothorax (P-THORAX)

A 
Pleuritic chest pain 
Tracheal deviaiton 
Haemodynamic compromise 
Onset sudden 
Reduced breath sounds 
Absent fremitus 
X-ray shows collapse
20
Q

What causes a tension pneumothorax

A

Air enters pleural space however cannot exit due to tissue forming a one-way valve system meaning air can enter pleural space but cannot leave.

21
Q

Why does haemodynamic instability occur in tension pneumothorax

A

Increase pressure causes a mediastinal shift impairing venous return to the heart

22
Q

What investigations are ordered in pneumothorax

A

CXR

ABG

23
Q

Explain presentation of pneumothorax on CXR

A
  • Increase radiolucency on affected side
  • On the affected side there is a thin white line - there
    are no lung markings peripheral to this
  • May be evidence of lung collapse
24
Q

What indications tension pneumothorax on CXR and why shouldn’t this be seen

A

Mediastinal shift.

CXR should not be ordered in tension pneumothorax

25
Q

Explain CXR in tension pneumothorax

A

Tension pneumothorax is a clinical diagnosis - do not order CXR

26
Q

If an individual is haemodynamically unstable or has bilateral pneumothoraces what is done

A

Insert chest drain

27
Q

If patient is haemodynamically stable with pneumothorax what is first-assessed

A

Whether this is primary or secondary pneumothorax based on:

  • Patient Over 50?
  • Smoking status?
  • Diagnosis of lung pathology?
28
Q

If primary pneumothorax and greater than 2cm and/or breathless what is done

A

Aspirate with 16-18G cannula

29
Q

What is the maximum that should be aspirated at one time

A

2.5L

30
Q

If a primary pneumothorax less than 2cm or asymptomatic what is done

A

Discharge and review as OP in 2-4W

31
Q

If secondary pneumothorax >2cm and/or person is breathless what is done

A

Chest Drain

32
Q

If secondary pneumothorax 1-2cm, what is done

A
  • Aspirate using 16-18G cannula
33
Q

If aspiration is unsuccessful what should individuals received

A

Chest drain

34
Q

What is a successful aspiration in primary pneumothorax

A

Pneumothorax is less than 1cm and reduction breathlessness

35
Q

What is a successful aspiration in secondary pneumothorax

A

Pneumothorax is less than 2cm and reduction in breathlessness

36
Q

What is problem with pneumothorax

A

High recurrence risk

37
Q

What can pneumothorax cause

A
  • Resp Failure

- HF (Tension Pneumothorax)

38
Q

If pneumothorax is less than 1cm in secondary pneumothorax, what is done

A

Admit for 24h for observations and oxygen

Respiratory (19 decks)

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