3.1 Pneumothorax

Question 1

How do we classify pneumothoraxes?

Answer 1

Spontaneous - without trauma
Traumatic - because of trauma e.g a penetrating chest wall injury

Simple - the mediastinal structures are not moved by the pressure of air.
Tension - a one way valve is created in the chest wall which causes extra pressure on the lung due to air only entering, not leaving the pleural cavity
Open - an open wound in the chest wall that allows air in and out

Primary - a spontaneous pneumothorax with no immediate underlying cause
Secondary - a spontaneous pneumothorax secondary to an underlying condition

Question 2

What are the risk factors for a primary spontaneous pneumothorax? (7)

Answer 2

Smoking
Tall and thin
Pregnancy
Marfan syndrome
Familial pneumothorax
Male
20-30 year old

Question 3

What is Marfan syndrome?

Answer 3

A genetic condition that effects the connective tissue

Question 4

What diseases can cause secondary spontaneous pneumothorax? (14)

Answer 4

COPD
Asthma
HIV with pneumocystis pneumonia
Necrotising pneumonia
Tuberculosis
Sarcoidosis
Cystic fibrosis
Bronchogenic carcinoma
Idiopathic pulmonary fibrosis
Severe ARDS
Langerhans cell histiocytosis lymphangioleiomyomatosis
Collagen vascular disease
Inhalation drug use, such as cocaine or marijuana
Thoracic endometriosis

Question 5

What can a PE present like on an ECG?

Answer 5

Sinus tachycardia