Pneumothorax

Question 1

What is a pneumothorax?

Answer 1

pneumothorax is air in the pleural space.

a tension pneumothorax is a medical emergency/

Question 2

What are the causes of acute SOB?

Answer 2

CAUSES OF ACUTE SOB

• exacerbation of COPD
• asthma
• pneumonia
• pneumothorax
• PE
• left ventricular failure
• diabetic ketoacidosis

Question 3

What are the causes of Chronic SOB?

Answer 3

Lungs:

• COPD
• Asthma
• recurrent PE

Cardiac:

• aortic valve stenosis
• Congenital heart disease
• Congestive cardiac failure

Other:
Anaemia

Question 4

What are the symptoms of pneumothorax?

Answer 4

• sudden onset SOB
• pleuritic chest pain
• tachycardic
• pale
• pts with asthma / COPD may present with sudden deterioration
• some pt may not have symptoms esp young, fit or if a small pneumothx

Question 5

What are the signs of pneumothorax?

Answer 5

• reduced expansion
• hyper resonance on percussion
• diminished breath sounds on affected side

Question 6

What is the sign of a tension pneumothorax?

Answer 6

Tracheal deviation away from affected side.

Question 7

What is the management of pneumothorax?

Answer 7

chest drain

aspiration of pneumothorax

Question 8

Who is most likely to be affected by a spontaneous pneumothorax?

Answer 8

young, thin men due to a rupture of a subdural bulla

Question 9

What are the causes of a pneumothorax?

Answer 9

1) spontaneous rupture of bullae
2) trauma
3) rare : asthma, COPD, TB, pneumonia, fibrosis, cystic fibrosis
4) Iatrogenic : insertion of a central venous line, pleural aspiration, biopsy

Question 10

what invx should be done for pneumothorax?

Answer 10

1) CXR - request expiratory film (but not in tension pneum –> insert chest drain immediately)
2) ABG

Question 11

Why is tension pneumothorax an emergency?

Answer 11

It is compressing the mediastinum and therefor the great vessels.

Unless air is removed cardiac arrest will occur.