Pneumothorax

Question 1

What is a Pneumothorax?

Answer 1

A collection of air in the pleural cavity

Question 2

What does a pneumothorax cause?

Answer 2

It results in the collapse of a lung

Question 3

What types of pneumothorax are there? (3)

Answer 3

1. Primary/Spontaneous
2. Secondary (associated with underlying disease)
3. Other: trauma, iatrogenic, catamenial (time of menstruation)

Question 4

What is a tension pneumothorax?

Answer 4

A medical emergency in which air becomes trapped in the cavity and pushes the mediastinum to one side/compressed

Question 5

Is pneumothorax common?

Answer 5

There are 30 per 100,000 a year

Question 6

Who is most affected?

Answer 6

Men between under 20 and above 60

Question 7

Risk factors (11)

Answer 7

Smoking, marfan’s, Endometriosis, subpleural plebs and bullae, COPD, TB, Sarcoidosis, CF, Malignancy, Idiopathic Pulmonary Fibrosis, Family History

Question 8

Symptoms (6)

Answer 8

*May be asymptomatic, sudden onset dyspnoea, pleuritic chest pain, sudden deterioration of COPD/Asthma, distress, sweating

Question 9

Signs (5)

Answer 9

Tachycardia, reduced chest expansion, hyperresonance on percussion, diminished breath sounds, deviated trachea

Question 10

Differentials (2)

Answer 10

Pleural Effusion, P.E

Question 11

Investigations (4)

Answer 11

Chest X-ray, Ultrasound, CT, ABG

Question 12

Treatment (6)

Answer 12

*suspected tension pneumothorax should be decompressed using a wide bore cannula before x-ray, Chest drain, oxygen therapy, pleurodesis, pleurectomy, avoid air travel until radiologically confirmed resolution

Question 13

Is there a good prognosis?

Answer 13

Death rates are low but recurrence is high (16% primary, 30% secondary)
Secondary associated with morbidity and mortality