Pneumothorax & effusion

Question 1

What is a pneumothorax

Answer 1

Air in pleural space (tension is where no air comes back out)
Common recurrence
No diving/change jobs/stop smoking/no high altitudes

Question 2

Symptoms of pneumothorax

Answer 2

SOB, chest pain, cough, increased resp rate

Question 3

Primary pneumothorax

Answer 3

In tall healthy young males (often smokers)
Apical bleb, tension rarely occurs
Drain/admission not always needed

Question 4

Secondary pneumothorax

Answer 4

Background of known lung disease

Need a drain, and tension more common

Question 5

Pleural Effusion

Answer 5

Large volumes of lubricating fluid between chest wall and pleura
Disturbances in hydrostatic and oncotic pressure, lymphatic drainage, altered permeability of pleural membranes

Question 6

Signs and symptoms of pleural effusion

Answer 6

SOB, cough, pleuritic chest pain

Reduced breath sounds, dull percussion

Question 7

Commonest causes of pleural effusion

Answer 7

Heart failure, pneumonia, malignancy

50% of pneumonias develop an effusion, 10% progress to empyema

Question 8

Uncomplicated parapneumonic effusion

Answer 8

Resolve underlying pneumonia

Question 9

Complicated parapneumonic effusion

Answer 9

Bacterial invasion into pleural space, drain needed

Fibrin deposition may form lobules

Question 10

Empyema

Answer 10

Pus in pleural cavity - thickening of pleural surface

Question 11

Treatment

Answer 11

Accurate diagnosis, antibiotics and chest drain if needed