PTX

Question 0

Treatment for initial small ptx

Answer 0

If stable & small

Observe & give high flow O2

(3L NC)

Question 1

Causes of secondary spontaneous pneumothorax

Answer 1

COPD
PJP
CF
Eosinophilic Granulomas (histiocytosis x)
LAM
Vents

Question 2

What is the size of a small ptx

Answer 2

<2cm

Question 3

If ptx is large treat?

Answer 3

Small ant chest tube

Question 4

Pneumothorax in patient with PPV

Answer 4

CT is mandatory

Question 5

What are the 3 chambers of a pleurevac

Answer 5

1st chamber: collection chamber
2nd chamber: water seal chamber
3rd chamber: suction chamber

Question 6

If there is a persistent air leak <90% expansion of the lung what do you do?

Answer 6

VATS staple the blebs or instil talc

Question 7

What does a persistent air leak >7 days suggest?

Answer 7

Bronchopleural fistula

Question 8

What reduces recurrence of PTX significantly?

Answer 8

Pleurodesis

Question 9

When do you do pleurodesis

Answer 9

Usually after 2nd secondary spontaneous ptx

But reasonable after 1st SSP

Question 10

What Is the best agent for pleurodesis?

Answer 10

Talc> doxy/minocycline

NOT bleomycine