Pneumothorax Flashcards

1
Q

where is air in pneumothorax

A

plural space

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2
Q

2 causative mechanisms of pneumothorax

A

Trauma to chest cavity

“Spontaneous” plural bleb rupture

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3
Q

Pathophysiology pneumothorax

A

Air escaping expands to fill pleural space (or part of it is adhesions between visceral and parietal pleura)
Increase in pressure causes lung to recoil and partially deflate

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4
Q

Tension Pneumothorax

A

often caused by NIV
valve formed over rupture meaning more air enters plural space on inspiration but cannot escape on expiration, trapped air increases pressure further with each breath causing lung to progressivley deflate.

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5
Q

RF Pneumothorax

A

Male
Tall thin body habitus
Smoking
Pre-existing Lung disease: COPD / Asthma / Ca / Abscess / TB
Connective tissue disorders: Marfans / Ehrlers-Danlos

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6
Q

Presentation Pneumothorax

A
Unilateral pleuritic chest pain
SOB (progressive)
Tachycardic
Reduced expansion
Hyper-resonance
Decreased breath sounds
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7
Q

Investigations pneumothorax

A

CXR

Can also be seen on US (fast scan) and CT (exact dimensions if considering surgery etc)

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8
Q

Conservative management of pneumothorax

A

If not breathless and <2cm (20% radiographic volume) of air on CXR
= 2 weekly reviews until air reabsorbed. initally avoid strenuous exercise

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9
Q

management of symptomatic or large pneumothorax

A

SOB +/ >2cm air on CXR
= Aspirate air. Review in clinic avoid strenuous exercise

IF recurs insert chest drain and follow up in clinic

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10
Q

management of recurrent pneumothorax

A

3 in a year = surgical review
Thoroscopy +/- bleb resection
or Chemical pleurodesis

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