pneumothorax

Question 1

classifications of pneumothorax

Answer 1

primary spontaneous pneumothorax
secondary spontaneous pneumothorax
traumatic pneumothorax
iatrogenic pneumothorax

Question 2

spontaneous pneumothorax in menstruating woman

Answer 2

catamenial pneumothorax- endometriosis ?

Question 3

presentation of pneumothorax

Answer 3

dyspnoea
chest pain: pleuritic
examination:
- hyper resonant lung percussion
- reduced breath sounds
- reduced lung expansion
- tachypnoea
- tachycardia

Question 4

management of pneumothorax in patient with no or minimal symptoms

Answer 4

conservative care

Question 5

high risk characteristics of pneumothorax

Answer 5

haemodynamic compromise
significant hypoxia
bilateral pneumothorax
underlying lung disease (COPD)
> 50 year smoking history
haemothorax

Question 6

management of symptomatic pneumothorax with no high risk characteristics

Answer 6

conservative care
- discharge with outpatient review every 2-4 days in those who are minimally symptomatic
ambulatory device
needle aspiration

Question 7

management of symptomatic and high risk pneumothorax

Answer 7

chest drain

Question 8

management of persistent or recurrent pneumothorax

Answer 8

chest drain -> video assisted thoracoscopic surgery

Question 9

discharge advice for patients with pneumothorax

Answer 9

stop smoking
don’t fly for 2 weeks
avoid scuba diving

Question 10

management of tension pneumothorax

Answer 10

decompression of pleural space via needle thoracostomy (inserting cannula into second intercostal space midclavicular line)
then placement of chest drain