topics / مواضيع

Pneumothorax

Answer is: D

Note: this is tracheobronchial injury, the usual hints are significant air leak even after 2 chest tube because the bronchioles are open in the pleura, sometime with subcutaneous emphysema. Dx: optic bronchoscope, Tx thoracotomy.

29 September 2022

13:02

Pneumothorax

SMLE Surgery 13.09.2022 13:08:23

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#pneumothorax

Which of the following indicate large uncomplicated pneumothorax?

a) Symmetrical chest movement.

b) Increase breath sound

c) Dull percussion note.

d) Tracheal deviation

e) Cracking sound with each heart beat

13:02

Pneumothorax

Pneumothorax:

Asymmetric

Decreased breath sound

Hyper resonant

Deviated mediastinum

13:02

3 October 2022

20:23

Pneumothorax

SMLE by Hamza 25.09.2022 10:14:45

1) 61 years old women sustain MVA to here left chest brought to ER vitally stable no open wound admitted for observation, couple of hours later developed suddenly SOB only, initial CXR reveled 3-7 left ribs features. Repeated CXR showed well demarcated left lung infiltarate. What is the diagnosis?

A- PE

B- flial chest

C- cardiac contusion

D- pulmonary contusions

My answer is D

6 October 2022

16:38

Pneumothorax

SMLE Surgery 13.09.2022 12:37:22

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#trauma

#pneumothorax

A 35 year-old car driver crashed into a concrete block without a safety belt on. Thirty minutes after and on the way by ambulance to the hospital he begins to become breathless. On administration of 100% oxygen there is not much improvement in this condition. On arrival at the Emergency Department he has lost consciousness and appears cyanosed with markedly distended jugular veins. Blood pressure 80/40 mmHg Heart rate 120/min Respiratory rate 34/min Temperature 36.6°C Oxygen saturation 60% on room air What immediate action should be taken?

A Intubation and 100% oxygen

B. Rapid infusion of crystalloid

C. Needle decompression

D IV 0.2 mg adrenaline

16:38

SMLE Surgery 13.09.2022 12:37:51

Answer is C

Here is clear scenario for traumatic pneumothorax.

16:38

Pneumothorax

SMLE killers -corrected Qs- 🤖 12.08.2022 09:59:14

A 35 year old car driver crashed into a concrete block without a safety belt on. Thirty minutes after and on the way by ambulance to the hospital he begins to become breathless. On administration of 100% oxygen there is not much improvement in this condition. On arrival at the Emergency Department he has lost consciousness (GCS 8) and appears cyanosed with markedly distended jugular veins. Blood pressure 80/40

Heart rate 120 /min

Respiratory rate 34 /min

Temperature 36.6 c

Oxygen saturation 60% on room air

What immediate action should be taken?

A. Intubation and 100% oxygen

B. Rapid infusion of crystalloid

C. Needle decompression

D. IV 0.2 mg adrenaline

16:38

Pneumothorax

فهد 06.10.2022 16:38:18

gcs 8 is indication for intubation

16:38

but intubation makes tension pneumothorax/traumatic pneumothorax worse

16:38

so needle

15 October 2022

14:06

Pneumothorax

SMLE by Hamza 19.09.2022 23:06:57

COPD patient developed sudden symptoms of spontaneous pneumothorax, x ray was done and showed 2 cm pneumothorax, mx?

A. Needle decompression

B. Chest tube

C. Observation

D. Aspiration

B or D ?

14:10

Pneumothorax

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14:22

In reply to this message

15:05

Pneumothorax

1ry pneumothorax:

Simple + unstable/large/recurrent/effusion > chest tube thoracostomy

None of abov > First: CXR then:

- Simple + stable + >/= 2cm/severe sx > aspiration/chest tube

- Simple + stable + <2cm > observe

2ry pneumothorax(COPD patient):

>/= 2cm = chest tube

<2cm = observe

Open pneumothorax > 3 sided dressing

Traumatic pneumothorax(after injury + not signs of tension pneumothorax) = needle thoracostomy(if unstable) > Chest tube thoracostomy

Jump to chest tube if stable.

Tension pneumothorax:

Tension = needle thoracostomy decompression > chest tube thoracostomy

cyanosis/jvp/= tension pneumothorax = Needle thoracostomy decompression > chest tube

15:12

Pneumothorax

SMLE by Hamza 19.09.2022 22:01:41

Young age male, previously well, presenting with 2 days Hx of SOB started after landing from an airplane. You notice he is a tall man CXR showing right pneumothorax (in a report with no image, and not telling the size). what is the initial management?

A- chest thoracostomy B- observation C- percutaneous aspiration D- needle decompression

15:13

Pneumothorax

Hunter SMLE MCQs discussion 22.09.2022 20:22:00

743- Tall man has spontaneous pneumothorax after landing from airplane has dyspnea absent Rt lung sound did CXR Rt pneumothorax no pics what’s the initial management? No size or site mentioned

A- chest thoracostomy

B- chest tube

C- observation

D- irrelevant

15:14

Pneumothorax

SMLE Surgery 26.09.2022 12:20:32

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#thoracic

Tall man has spontaneous pneumothorax after landing from airplane has dyspnea absent Rt lung sound did CXR Rt pneumothorax no pics what’s the initial management? No size or site mentioned

A- chest thoracostomy

B- chest tube

C- observation

D- irrelevant

17:40

Pneumothorax

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17 October 2022

10:59

Pneumothorax

SMLE by Hamza 18.09.2022 20:40:30

Patient post RTA with massive bleeding in the nose and mouth with leg fracture, decrease bp, Pt can take his breath but he is afraid from what happened. What is the next step?

A. Intubate with stretching cervix

B. Packing nasal bleeding

C. IV fluid

D. Cricothyroidotomy

20 December 2022

19:04

Pneumothorax

50 year old sustained blunt trauma to the chest with persistent pneumothorax and significant air leak through double intercostal tubes ( ICT ) . Which of the following is the most appropriate next procedure ?

A.Reposition of ICT

B.Prompt thoracotomy to treat

C.Endotracheal intubation

D.Fiber - optic bronchoscopy to diagnose

Air leak after chest tube = tracheobronchial injury

-because the bronchioles are open in the pleura, sometime with subcutaneous emphysema. Dx: optic bronchoscope, Tx thoracotomy.

19:04

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19:06

A.Reposition of ICT