Pneumothorax

• What is a pneumothorax?

  Air within the pleural space = lung collapse
• What sex is pneumothorax more common in?

  Males
• What are some risk factors for pneumothorax?

  Tall, lean males

  Pre-existing lung disease

  Connective tissue disease - Marfan's

  Ventilation
• What are the different types of pneumothoraces?

  Primary

  Secondary

  Traumatic

  Tension

  Iatrogenic
• What is primary spontaneous pneumothorax?

  Occurs without underlying lung disease
• What is PSP associated with?

  Rupture of subpleural blebs or bullae
• Who is PSP more common in?

  Tall, thin, young individuals
• What is secondary spontaneous pneumothorax?

  Occurs in those with pre-existing lung diseases
• What is a traumatic pneumothorax?

  Occurs from penetrating or blunt chest trauma
• What is iatrogenic pneumothorax

  Occurs due to a complication of medical procedures
• What is a tension pneumothorax?

  Severe pneumothorax resulting in the displacement of mediastinal structures
• How may a patient with a pneumothorax present?

  Sudden onset pleuritic chest pain

  Dyspnoea
• What are some physical examination findings for a pneumothorax?

  Dec breath sounds

  Hyper resonance (percussion)

  Dec chest wall movement

  Hypoxia

  Tachypnoea

  Tachycardia

  Hypotension
• How may someone present with a tension pneumothorax?

  Severe resp distress

  Tracheal deviation

  Jugular venous distention

  Haemodynamic instability
• What investigations are done for a pneumothorax?

  Chest X-ray (first line)

  CT scan
• How is the management for pneumothorax decided?

  Whether the patient is symptomatic and the presence of high-risk characteristics
• How is a pneumothorax managed?

  Conservatively

  Ambulatory

  Needle aspiration

  Chest drain
• What is the discharge advice given for patients who have had a pneumothorax?

  Avoid smoking

  No flying until there is no residual air after a successful drainage

  Scuba diving should be permanently avoided
• What are some immediate complications of a pneumothorax?

  Tension pneumothorax

  Re-expansion pulmonary oedema

  Infection
• What are some long-term complications of pneumothorax?

  Recurrence

  Blebs and bullae formation

  Pleural thickening or fibrosis
• What are blebs and bullae?

  Air-filled sacs that can form on the surface of the lungs -> may rupture = recurrent episodes of pneumothorax