PNEUMOTHORAX

Question 1

What is it?

Answer 1

abnormal collection of air in the pleural space that causes uncoupling of the lung from the pleural space (DEFLATION OF THE LUNG)

Question 2

What is primary spontaneous pneumothorax (PSP)?

Answer 2

a pneumothorax that occurs without any precipitating event and in the absence of clinical lung disease

Question 3

What ages are commonly affected by PSP?

Answer 3

in 20s

Question 4

What is secondary spontaneous pneumothorax (SSP)?

Answer 4

a pneumothorax that occurs under the complication of an underlying disease

Question 5

What ages tend to be affected by SSP?

Answer 5

60-65 yr olds

Question 6

What is the risk factor for spontaneous pneumothorax and what causes it? (4,1)

Answer 6

• tall
• thin
• male
• 20s

CAUSE

• rupture of sub-pleural bulla

Question 7

What underlying medical condition tends to cause a pneumothorax?

Answer 7

COPD

Question 8

What are the symptoms? (2)

Answer 8

1. sudden onset of unilateral pleuritic pain

2. progressively increased breathlessness

Question 9

What are the signs? (3)

Answer 9

1. reduced expansion
2. hyperressonance on percussion
3. diminished breath sounds on affected side

Question 10

What sign will you see in tensional pneumothorax?

Answer 10

• tracheal deviation away from the pneumothorax

Question 11

Differential diagnosis

Answer 11

1. pleural effusion
2. chest pain
3. PE

Question 12

Investigations (4)

Answer 12

1. CXR
2. CT
3. US
4. ABG

Question 13

When would you do an ABG?

Answer 13

if hypoxic

Question 14

Treatments (4)

Answer 14

1. chest drain
2. oxygen
3. thoracocentesis/ pleural tap
4. surgery - PLEURODESIS, pleurectomy, pleural abrasion, bullectomy