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An 18-Year-Old Man Comes to the Emergency Department with Sudden-Onset

question 423

Multiple Choice

An 18-year-old man comes to the emergency department with sudden-onset right-sided chest pain and dyspnea. The patient was at home watching a football game on television when his symptoms abruptly started. He now has pain with deep breaths. He has no other medical problems and takes no medications. The patient has smoked a pack of cigarettes daily for the past 2 years. His respirations are 24/min. Physical examination shows a thin, tall patient in acute distress. The right side of the chest is hyperresonant to percussion and lacks audible breath sounds. His chest x-ray is shown below. Which of the following conditions most likely led to this patient's presentation?

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