Respiratory

Question 1

Management of small primary pneumothorax without significant breathlessness?

Answer 1

Discharged with written advice and follow up.

Question 2

Management of primary pneumothorax >2cm or with significant breathlessness?

Answer 2

Attempt aspiration (up to 2.5L), if then <1cm then admit for observation. If not insert chest drain.

Question 3

Management of secondary pneumothoraces (aged over 50 and significant smoking history)?

Answer 3

Insert chest drain

Question 4

How do you definitively diagnose PAH?

Answer 4

Right heart catheterisation, can estimate based on Echo findings

Question 5

Conditions associated with pulmonary hypertension?

Answer 5

Systemic sclerosis/RA/SLE

Question 6

Advice following discharge for pneumothorax

Answer 6

If no intervention should have CXR in 2-4 weeks to ensure resolution.
Advise to stop smoking.
Scuba diving should be avoided for life.
Advise waiting 2 weeks following resolution of a PTX before flying.
All should be ideally followed up by a respiratory physician.