Pneumothorax

Question 1

Presence of gas in the pleural space. (Harrison’s 19th edition, pp 1719)

Answer 1

Pneumothorax

Question 2

Pneumothorax that occurs without antecedent trauma to the thorax. (Harrison’s 19th edition, pp 1719)

Answer 2

Spontaneous pneumothorax

Question 3

Pneumothorax that occurs in the absence of underlying lung disease. (Harrison’s 19th edition, pp 1719)

Answer 3

Primary spontaneous pneumothorax

Question 4

Pneumothorax that occurs in the presence of underlying lung disease. (Harrison’s 19th edition, pp 1719)

Answer 4

Secondary pneumothorax

Question 5

Pneumothorax that results from penetrating or nonpenetrating chest injuries. (Harrison’s 19th edition, pp 1719)

Answer 5

Traumatic pneumothorax

Question 6

Pneumothorax in which the pressure in the pleural space is positive throughout the respiratory cycle. (Harrison’s 19th edition, pp 1719)

Answer 6

Tension pneumothorax

Question 7

The usual cause of primary spontaneous pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 7

Rupture of apical pleural blebs

Question 8

Small cystic spaces that lie within or immediately under the visceral pleura. (Harrison’s 19th edition, pp 1719)

Answer 8

Pleural blebs

Question 9

Primary spontaneous pneumothoraxes occur almost exclusively in? (Harrison’s 19th edition, pp 1719)

Answer 9

Smokers

Question 10

The initial recommended treatment for primary spontaneous pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 10

Simple aspiration

Question 11

Treatment for recurrent pneumothorax or if the lung does not expand with aspiration. (Harrison’s 19th edition, pp 1719)

Answer 11

Thoracoscopy with stapling of blebs and pleural abrasion

Question 12

Success rate of thoracoscopy or thoracotomy with pleural abrasion in preventing recurrences. (Harrison’s 19th edition, pp 1719)

Answer 12

100%

Question 13

Most common cause of secondary pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 13

Chronic obstructive pulmonary disease

Question 14

Nearly all patients with secondary pneumothorax should be treated with? (Harrison’s 19th edition, pp 1719)

Answer 14

Tube thoracostomy

Question 15

Most patients with secondary pneumothorax should also be treated with? (Harrison’s 19th edition, pp 1719)

Answer 15

Thoracoscopy or thoracotomy with the stapling of blebs and pleural abrasion

Question 16

Treatment for secondary pneumothorax if the patient is not a good operative candidate or refuses surgery. (Harrison’s 19th edition, pp 1719)

Answer 16

Pleurodesis (intrapleural injection of a sclerosing agent such as doxycycline)

Question 17

Treatment for traumatic pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 17

Tube thoracostomy

Question 18

Treatment for hemopneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 18

Tube thoracostomy
1 tube in the superior part of the hemothorax (air)
1 tube in the inferior part (blood)

Question 19

Leading causes of Iatrogenic type of traumatic pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 19

Transthoracic needle aspiration
Thoracentesis
Insertion of central intravenous catheters

Question 20

Treatment for Iatrogenic type of traumatic pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 20

Supplemental oxygen or aspiration

If unsuccessful, tube thoracostomy should be performed

Question 21

Tension pneumothorax usually occurs during? (Harrison’s 19th edition, pp 1719)

Answer 21

Mechanical ventilation or resuscitative efforts

Question 22

Life threatening results of tension pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 22

Severely compromised ventilation
Decrease venous return
Reduced cardiac output

Question 23

Diagnostic physical examination for Tension pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 23

Enlarged hemithorax with no breath sounds
Hyperresonance to percussion
Shift of the mediastinum to the contralateral side

Question 24

Treatment for tension pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 24

Large-bore needle insertion at the 2nd anterior intercostal space
If large amount of gas escape from the needle (confirmatory diagnosis), the needle should be left in place until a thoracostomy tube can be inserted

Question 25

Cause of death in tension pneumothorax. (Harrison’s 19th edition, pp 1719)

Answer 25

Inadequate cardiac output

Marked hypoxemia