Pneumothorax Flashcards

1
Q

What is the definition of a pneumothorax?

A

Air in the pleural space leading to partial or complete collapse of the lung

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2
Q

How common is a pneumothorax?

A

Primary spontaneous pneumothorax: 24/100000 a year in men and 9.9/100000 in woman in England

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3
Q

What is the pathology of a pneumothorax?

A

(see sheet for x rays)
• Tension pneumothorax:
• Air passes in during inspiration but unable to exit during expiration
• Unilateral ↑ in intrapleural pressure

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4
Q

What are the risk factors/aetiology of a pneumothorax?

A
  • Young men that are tall and thin e.g. Marfans – rupture of pleura due to congenital defect in connective tissue of the alveolar wall
  • Spontaneous
  • Underlying lung disease e.g. COPD
  • Mechanical ventilation – tension pneumothorax
  • Nasal non invasive ventilation – tension pneumothorax
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5
Q

What are the signs/symptoms of a pneumothorax?

A
•	Sudden onset of pleuritic chest pain
•	Sudden onset of breathlessness
•	↓ breath sounds
•	Hyperresonant percussion  
Tension = tracheal deviation
•	Sweating
•	Distressed patient 
•	Tachycardic
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6
Q

What diseases present similarly to a pneumothorax?

A
  • Pleural effusion
  • Chest pain
  • PE
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7
Q

What investigations are required to diagnose a pneumothorax?

A
  • Tension = clinical
  • CXR
  • CT – differentiates emphysematous bullae from pneumothoraces
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8
Q

What information should a patient with a pneumothorax be given about flying and driving?

A

Patients are advised not to fly for 2 weeks after successful treatment
Patients are advised not to dive unless surgery is performed to prevent recollapsing of the lung

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9
Q

What are the surgical treatments for pneumothorax?

A
  • Tension pneumothorax:
  • Immediate decompression by needle thoracocentesis (2nd intercostal space, mid clavicular line)
  • Intercostal tube drainage
  • Aspiration of air
  • Pleurectomy – removal of pleura
  • Pleurodesis – pleural space is artificially obliterated
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10
Q

What are the pharmacological treatments for pneumothorax?

A

• High flow oxygen

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11
Q

What are the non pharmacological treatments for pneumothorax?

A
  • Avoid strenuous activity

* Smoking cessation

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