Pneumothorax Flashcards
_____ is the presence of gas in the pleural space.
Pneumothorax
A _____ is one that occurs without antecedent trauma to the thorax.
spontaneous pneumothorax
A ________ occurs in the absence of underlying lung disease,
primary spontaneous pneumothorax
A _____results from penetrating or nonpenetrating chest injuries.
traumatic pneumothorax
A ______ is a p horax in which the pressure in the pleural space is positive throughout the respiratory cycle.
tension pneumothorax
A _____ occurs in the presence of underlying disease
secondary pneumothorax
____are usually due to rupture of apical pleural blebs, small cystic spaces that lie within or immediately under the visceral pleura.
Primary spontaneous pneumothoraces
The initial recommended treatment for primary spontaneous pneumothorax is ____
simple aspiration
Most secondary pneumothoraces are due to ____
chronic obstructive pulmonary disease
If the patient is not a good operative candidate or refuses surgery, ____ should be attempted by the intrapleural injection of a sclerosing agent such as ___.
pleurodesis
doxycycline
Traumatic pneumothoraces should be treated with____unless they are very small.
tube thoracostomy
If a hemopneumothorax is present, one chest tube should be placed in the ____ part of the hemithorax to evacuate the air and another should be placed in the _____ part of the hemithorax to remove the blood.
superior
inferior
The leading causes of iatrogenic pneumothorax are _______
Transthoracic needle aspiration
Thoracentesis
Insertion of central intravenous catheters.
[Tension Pneumothorax] A large-bore needle should be inserted into the pleural space through the ____
Second anterior intercostal space
Which of the following conditions is most commonly associated with primary spontaneous pneumothorax?
A. Asthma
B. Chronic obstructive pulmonary disease (COPD)
C. Smoking
D. Pulmonary embolism
C
Which of the following is the initial recommended treatment for a primary spontaneous pneumothorax?
A. Tube thoracostomy
B. Pleurodesis with doxycycline
C. Simple aspiration
D. Thoracotomy
C
What procedure is performed if a patient with a primary spontaneous pneumothorax has recurrent episodes or failure of lung expansion after aspiration?
A. Thoracoscopy with stapling of blebs and pleural abrasion
B. Tube thoracostomy
C. Needle aspiration
D. Pleurodesis with sclerosing agents
A
Which of the following is the most common cause of secondary pneumothorax?
A. Asthma
B. Pneumonia
C. COPD
D. Tuberculosis
C
In tension pneumothorax, which physical finding is most likely to be observed?
A. Bilateral wheezing
B. Tracheal deviation toward the affected side
C. Hyperresonance on percussion of the affected side
D. Dullness to percussion on the affected side
C
Which of the following strongly suggests the diagnosis of tension pneumothorax during mechanical ventilation?
A. Persistent hypoxemia despite supplemental oxygen
B. High peak inspiratory pressures
C. Slow capillary refill
D. Bradycardia
B
How should an iatrogenic pneumothorax due to central line placement be initially managed?
A. Thoracotomy
B. Needle decompression
C. Supplemental oxygen or aspiration
D. Tube thoracostomy
C
What is the most appropriate intervention for a secondary pneumothorax in a patient who is not a surgical candidate?
A. Needle aspiration only
B. Pleurodesis with sclerosing agents
C. Tube thoracostomy alone
D. Observation with supportive care
B
What is the most definitive treatment for recurrent primary spontaneous pneumothorax?
A. Repeated needle aspiration
B. Supplemental oxygen only
C. Thoracoscopy with pleural abrasion
D. Long-term oxygen therapy
C
