Author: Jasreen Dhother, Riad Hosein / Editor: Nick Tilbury / Codes: ResC8, ResC9, SLO2, SLO3, SLO6 / Published: 08/09/2023
A 32-year-old female presents to the Emergency Department (ED) with a four day history of pleuritic chest pain and progressive shortness of breath (SOB) at rest.
The patient has recently returned to the UK from a long haul flight. She is an ex-smoker but currently vapes every day. She has no other past medical history of note and is on no regular medication.
Observations are as follows:
- Respiratory rate: 22 breaths per minute
- SpO2: 94% on room air
- Blood pressure:125/85
- Heart rate: 120 beats per minute
On examination, she is able to speak in full sentences. Auscultation reveals good air entry of the left lung, but absent breath sounds in all lung fields of the right lung. ECG shows sinus tachycardia.
An urgent PA chest radiograph shows a right sided spontaneous pneumothorax:

Exam Summary
0 of 3 Questions completed
Questions:
Information
You have already completed the exam before. Hence you can not start it again.
Exam is loading...
You must sign in or sign up to start the exam.
You must first complete the following:
Results
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- 2
- 3
- Current
- Review
- Answered
- Correct
- Incorrect
-
Question 1 of 3
1. Question
According to the British Thoracic Society, what it is the best acute management for this patient?
CorrectIncorrect -
Question 2 of 3
2. Question
This patient undergoes needle aspiration of 2.5 litres in a monitored setting in resus and a post-procedure chest x-ray confirms reinflation of the lung.
Fig. 4
Two hours after the procedure, the patient suddenly becomes breathless. She now has an oxygen requirement of 2 litres and has become hypotensive and tachycardic.
A further chest x-ray is done:
Fig. 5
What complication(s) is this patient most likely suffering from? (select all that apply)
CorrectIncorrect -
Question 3 of 3
3. Question
Which of the following is false regarding pneumothoraces?
CorrectIncorrect
Module Content
Related Posts
Spontaneous Pneumothorax
This session covers the assessment and management of primary, secondary and tension pneumothoraces.
Breathlessness
Dyspnoea is an overall term used to describe an unpleasant awareness of increased respiratory effort and will be used synonymously with "breathlessness" in this session.
Pleural Effusion
This session looks at the assessment and management of the adult with a pleural effusion in the ED.
One Response
Nice case and knowledge