Pleural Diseases

Question 1

What is a pneumothorax

Answer 1

Air in the pleural space; classified based on etiology

Question 2

Etiology, epidemiology, and risk factors of primary pneumothorax

Answer 2

No known underlying lung condition;
Tall, thin males have an increased incidence;
Risk Factors: smoking, FHx, Marfan’s syndrome

Question 3

Etiology, epidemiology and pathophysiology of secondary spontaneous pneumothorax

Answer 3

Airway disease: COPD (rupture of apical blebs), lung malignancy, cystic fibrosis
Necrotizing lung infections: TB, pneumocystis jiroveci pnumonia (AIDS), lung abscess
Interstitial lung disease: idiopathic pulmonary fibrosis, sarcoidosis

Question 4

Etiology and pathophysiology of tension pneumothorax

Answer 4

Increased air pressure in pleural space (increased intrapleural pressure exceeds atmospheric pressure)
Unidirectional flow of air from injured lung into plueral space if its closed
Flow is driven by positive pressure (either during expiration or during positive pressure ventiliation)

Question 5

Definition of Hemothorax

Answer 5

Blood in the pleural space

Question 6

Definition of Hemopneumothorax

Answer 6

Blood and/or air enter pleural space

Question 7

Definition of Flail chest

Answer 7

two or more ribs broken in 2 or more places which leads to paradoxical movement

Question 8

Definition of Iatrogenic Pneumothorax

Answer 8

Caused by surgery or biopsy

Question 9

What are the expected x-ray findings of a pneumothorax?

Answer 9

Upright/supine and lateral views and inspiratory views show unilateral lucency, a line along the edge of the lung, deviation of the trachea and mediastinum if it is a tension pneumothorax. May also see fluid present

Question 10

What is the equation to estimate degree of pneumothorax?

Answer 10

100- (d³/D³x100)
d=size of collapsed lung (mid chest to edge of lung)
D= size of hemithorax (mid chest to chest wall)