Primary Spontaneous Pneumothorax – Board-Style Questions

What this deck covers

Primary Spontaneous Pneumothorax in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Nothing to hear
2. A ruler on the film
3. A scan for the parents
4. Big rim, little bother
5. Breathless on the trolley
6. Still down after the needle
7. Going home with it in
8. Before the trip to X-ray
9. Pink froth within the hour
10. Still bubbling on day five
11. The other lung this time
12. What he does at weekends
13. The family holiday
14. Under the sea after surgery
15. Back on the pitch
16. Long fingers, loose lenses
17. His father’s face
18. The timing of each one

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Pneumothorax is excluded, as breath sounds are equal, By the share of the hemithorax that looks too dark, It should be done now, since blebs decide, Manage without a procedure, with clinic review soon, Needle aspiration of the air through a small cannula, Repeat the aspiration two or three more times, A large-bore drain on an underwater seal, on a ward, Pneumonia introduced when the drain was inserted, Early referral to the thoracic surgeons for VATS, Stop smoking both tobacco and cannabis completely, He may fly, as he now has no symptoms at all, Give up contact sport permanently after any episode, A CT scan of the chest to look for apical blebs, Tuberous sclerosis.

Clinical pearls from this deck

• A small pneumothorax can be silent to the stethoscope; the history is not.
• Measure at the hilum: two centimetres is the line between small and large.
• A first, simple pneumothorax needs a film, not a scanner.
• Treat the patient, not the ruler: minimal symptoms, minimal intervention.
• Breathless with a first primary pneumothorax: the needle comes before the tube.
• When the needle fails, go small with the drain, not big.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Respiratory case decks · pediatric reference values.