Pneumothorax

Question 1

Types of pneumothorax

Answer 1

Closed

Open

Tension

Question 2

Closed pneumothorax

Answer 2

intact chest wall air leaks from lung into pleural space

Question 3

Open pneumothorax

Answer 3

defect in chest wall

Question 4

Tension pneumothorax

Answer 4

Air enters through 1 way valve cannot escape

• mediastinal compression

Question 5

Causes of pneumpthorax

Answer 5

1. Spontaneous
2. Trauma
3. Iatrogenic: e.g. Subclavian CVP line insertion

Question 6

Primary spontaneous pneumothorax

Answer 6

no underlying lung disease

Question 7

Primary spontaneous pneumothorax typical pt

Answer 7

young, thin men

smokers

Question 8

Secondary spontaneous pneumothorax causes

Answer 8

COPD,

Marfan’s,

Ehler’s Danlos,

Pulmonary fibrosis,

sarcoidosis

Question 9

Symptoms of pneumothorax

Answer 9

Sudden onset

Dyspnoea

Pleuritic chest pain

Tension: respiratory distress, cardiac arrest

Question 10

Signs of pneumothorax

Answer 10

Chest:↓ expansion

Resonant percussion

↓ breath sounds

↓VR

Tension: ↑JVP, mediastinal shift, ↑HR, ↓BP

Crepitus: surgical emphysema

Question 11

Tension pneumothorax treatment

Answer 11

Resuscitate pt.

Large bore Venflon into 2nd ICS, mid-clavicular line

Insert chest drain

Question 12

Traumatic pneumothorax treatment

Answer 12

Resuscitate pt.

Analgesia: e.g. morphine

3-sided wet dressing if sucking

Insert ICD

Question 13

Primary pneumothorax treatment

Answer 13

No SOB/<2cm

• consider discharge

SOB/>2cm

• aspirate (chest drain if unsuccessful)

Question 14

Secondary pneumothorax treatment

Answer 14

If SOB/>2cm/>50yrs: insert chest drain

1- 2cm: Aspirate

<1 cm: admit for 24hrs