Pneumothorax

Question 1

Causes:

Answer 1

1. Spontaneous (especially in young thin men) due to rupture of a subpleural bulla
2. Chronic lung disease - asthma; COPD; cystic fibrosis; lung fibrosis; sarcoidosis
3. Infection - TB; pneumonia; lung abscess
4. Traumatic
5. Carcinoma
6. CTD - Marfan’s syndrome, Ehlers–Danlos syndrome

Question 2

Acute Mx of primary pneumothorax:

Answer 2

1. SOB and/or rim of air >2cm on CXR - YES
2. Aspiration - successful? - NO
3. Consider repeat aspiration - Successful? - NO
4. Chest drain

Question 3

Acute Mx of secondary pneumothorax:

Answer 3

1. SOB and age >50 and rim of air >2cm on CXR? - YES
2. Chest drain

Question 4

Signs tension pneumothorax:

Answer 4

1. RDS
2. Tachycardia
3. Hypotension
4. Distended neck veins
5. Trachea deviated away from side of pneumothorax
6. Increased percussion note
7. Reduced air entry/breath sounds on the affected side