A 24-year-old tall, slender male presents with sudden unilateral pleuritic chest pain and shortness of breath. Chest auscultation reveals absent breath sounds on the right. What is the most likely diagnosis?
Answer and explanation
Correct answer: C. Primary Spontaneous Pneumothorax
- Step 1: Tall, slender young adults with no prior pulmonary disease are predisposed to increased transpulmonary pressure gradients at the lung apices, leading to the formation and rupture of apical subpleural blebs.
- Step 2: The sudden onset of unilateral pleuritic chest pain, dyspnea, and absent ipsilateral breath sounds are classic diagnostic hallmarks of primary spontaneous pneumothorax.
Answer
Primary Spontaneous Pneumothorax.
Why not the others: Pulmonary embolism presents with clear lung fields and tachycardia, myocardial infarction causes ischemic ECG abnormalities, and lobar pneumonia produces crackles, bronchial breath sounds, and purulent sputum.
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