Pneumothorax

Question 1

Presentation of Pneumothorax

Answer 1

Usually young tall males
(or smokers)
can be primary or secondary

With acute onset SOB and Pleural chest pain
(or tension-resp distress, tachy etc)

Hyperresonant chest on the affected side
Trachea away from affected side
Silent lung of affected side
Hyporesonant vocal fremitus

can go to tamponade (JVP up, no change with breath, HS quiet, hypotense)

Question 2

Ix of Pneumothorax

Answer 2

usually diagnosis on XRAY
but should be mainly clinical
can use xray to measure size

“tension pneumo on xray is a missed diagnosis”

Question 3

Mx of pneumothorax

Answer 3

Primary–

Small- <2cm, young, causing no SOB- clinic after a few weeks

> 2cm, symptomatic but no tension- aspiration, then drain if needed

tension- needle decompression

Secondary-
<2cm - asipirate
>2cm- chest drain
both should stay in hosp