A 22-year-old tall, thin man develops acute pleuritic right-sided chest pain and dyspnea while playing basketball. Vital signs show BP 118/76 mmHg, HR 102/min, RR 22/min, temperature 37.2°C, and SpO2 92% on room air. Examination reveals decreased breath sounds at the right apex with normal tracheal position. Chest radiograph shows a small right apical pneumothorax without mediastinal shift. He denies recent trauma or prior lung disease. Which diagnosis is most likely?

  1. A)Pleural effusion
  2. B)Pulmonary embolism
  3. C)Spontaneous pneumothoraxGABARITO
  4. D)Primary pulmonary hypertension due to BMPR2 mutation
  5. E)Community acquired pneumonia

Explicação

Spontaneous pneumothorax is correct. A tall thin young man with sudden unilateral pleuritic pain and an apical pleural air collection has the classic presentation of rupture of a subpleural bleb. The absence of mediastinal shift argues against tension physiolo... Ver explicação completa e trilha adaptativa →

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