Pneumothorax and haemoptysis Flashcards Preview

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Flashcards in Pneumothorax and haemoptysis Deck (12)
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Differentiate a tension pneumothorax from a large pneumothorax

Tension pneumothorax features haemodynamic instability (hypotension, tachycardia)


State the causes of a tension pneumothorax

Rib fracture Mechanical ventilation Failed central venous cannulation


Outline signs seen in tension pneumothorax

Respiratory distress Tachycardia Hypotension Raised JVP Tracheal shift Hyper resonant percussion Reduces breath sounds


Describe the urgent treatment of a tension pneumothorax

Temporary: Large bore needle with saline, or cannula decompression in 2nd intercostal space MCL of affected side. Definite: Chest drain


What is the triangle of safety?

Anatomical landmark for the insertion of chest drains.

  • Superior: base of axilla
  • Anterior: lateral edge of pectoralis major
  • Posterior: anterior border of latissimus dorsi
  • Inferior: horizontal line at level of nipple


Define massive haemoptysis

>240ml/24hr, or >100ml/24hr over consecutive days


What key questions should you ask if massive haemoptysis is suspected?

Nature and volume of haemoptysis Weight loss Drug Hx Smoking


List the commonest causes of massive haemoptysis

TB Bronchiectasis Carcinoma


List causes of massive haemoptysis

- Respiratory: infection, bronchiectasis, carcinoma - Cardiovascular: PE, ruptured aortic aneurysm, pulmonary oedema - Coagulation disorders: Drugs^, inherited conditions* - Trauma - Vasculitis (granulomatosis with polyangiitis) and Good pasture's ^ NSAIDs, Anticoagulants, Antiplatelets * Von Willebrands disease (vWF deficiency) and haemophilia


What is the key investigation and treatment of massive haemoptysis?

Ix: CT angiogram Tx: Embolism or ligation


When is a CT angiogram contraindicated?

Renal failure Contrast allergy


What would an empyema feature on aspiration?

Yellow turbid fluid pH <7.2 Low glucose High LDH