pneumothorax

Question 1

Symptoms of a pneumothorax

Answer 1

sudden onset:
pleuritic pain
SOB

Question 2

signs of a pneumothorax

Answer 2

decreased breath sounds
increased percussion note (hollow)
hyper-resonant chest 
decreased chest expansion
mediastinal shift (tension)
sweating
tachcardia

Question 3

when does a pneumothorax need drainage?

Answer 3

if large (>30% of pleural area)
persistent SOB
?tension pneumothorax

Question 4

How do you treat a tension pneumothorax

Answer 4

emergency
call for help
sit the pt up if possible
insert a large (12-16bore) cannula into 2nd intercostal space
will later need replacement with underwater sealed drainage

Question 5

what is the rate of recurrence for a spontaneous pneumothoraX?

Answer 5

30-50% recur, most within 12 months, most on the same side

Question 6

what type of imaging do you want

Answer 6

expiration CXR

Question 7

what groups of people tend to have spontaneous pneumothorax?

Answer 7

pts with hx of asthma or emphysema

young slender males (6:1 more common than females)

Question 8

what risk factors are there for spontaneous pneumothorax

Answer 8

previous pneumothorax
smoking
diving
ascent in an aeroplane
pneumonia
tb
lung cancer
fibrosis

Question 9

how do you rx traumatic pneumothorax

Answer 9

same as spontaneous - consider drainage based on size and symptoms

Question 10

what are the common causes of pneumothorax

Answer 10

40yrs usually due to COPD
rarer:
asthma
pneumonia
tb
lung cancer
fibrosis