Pneunothorax

Question 1

Pathophysiology

Answer 1

Air in pleural space, compresses lung causing collapse. Can cause haemodynamic instability if large.

Question 2

Primary Spontaneous Causes

Answer 2

Rupture of subpleural blebs, in tall thin young males.

Question 3

Secondary Spontaneous Causes

Answer 3

COPD, TB, Sarcoidosis

Question 4

Traumatic

Answer 4

Rib fracture, Penetration wounds

Question 5

Idiopathic

Answer 5

Central line, Pacemaker wires, mechanical ventilation

Question 6

Tension

Answer 6

Large pneumothorax, haemodynamically unstable
tracheal deviation
mediastinal shift

Question 7

Treatment

Answer 7

If symptomatic and air brim > 2cm on CXR
Aspirate
If unsuccesful - Re Aspirate, Consider drain.
If persists > 5d refer to thoracic surgery
If asymptomatic - observe
No diving or Flying until resolved

Question 8

Investigations

Answer 8

CXR

Question 9

CXR Signs

Answer 9

Air brim, Hyperlusency, Loss of lung markings, flattening of diapraghm

Question 10

Treatment tension

Answer 10

A-E
Oxygen
Analgesia
Needle decompression
2nd IC just above rib, MCL