Pneumothorax

Question 1

Risk factors for primary spontaneous pneumothorax

Answer 1

Tall thin male, smoking, family history

Question 2

Risk factors for secondary pneumothorax

Answer 2

Underlying lung disease, smoking

Question 3

Symptoms of pneumothorax (4)

Answer 3

1. Sudden onset SOB
2. Pleuritic chest pain
3. Cough
4. Fatigue

Question 4

Signs of pneumothorax (4)

Answer 4

1. Decreased breath sounds
2. Hyperresonant percussion
3. Decreased vocal resonance / tactile fremitus
4. Cyanosis/low sats

Question 5

Signs of pneumothorax on CXR and CT

Answer 5

CXR: linear shadow, mediastinal shift away, deep sulcus sign, effusions

CT: blebs, bullae

Question 6

Management of pneumothorax, including where to place the chest tube

Answer 6

1. Small - no treatment
2. Secondary - needle decompression
3. Large/tension - chest tube

Tension - 2nd ICS MCL
Non-tension - 5th ICS MAL

4. Pleurodesis, pleurectomy