A 22-Year-Old Man Comes to the Emergency Department Due to Sudden-Onset

question 302

Multiple Choice

A 22-year-old man comes to the emergency department due to sudden-onset dyspnea 2 hours ago while watching television.  The patient's dyspnea is gradually improving but he still has sharp right-sided chest pain that is worse with deep inspiration or cough.  His medical history is unremarkable.  The patient smokes 4-5 cigarettes daily and occasionally drinks alcohol.  Temperature is 36.7 C (98 F) , blood pressure is 140/80 mm Hg, pulse is 86/min, and respirations are 18/min.  Pulse oximetry shows 98% on room air.  He weighs 68 kg (150 lb) , is 188 cm (6 ft 2 in) tall, and has a BMI of 19.3 kg/m².  Physical examination is unremarkable.  Chest x-ray reveals a small right apical pneumothorax.  Which of the following is the most appropriate management of this patient?

• A)Chest tube placement
• B)CT scan of the chest
• C)Needle thoracostomy
• D)Supplemental oxygen
• E)Talc pleurodesis

---

Definitions:

Religious Orientation

A person's affiliation or relationship with a particular religion or system of belief, including atheism, agnosticism, and secularism.

South Vietnamese

Refers to the people, culture, or aspects of the former Republic of Vietnam, located in the southern part of Vietnam.

Catholic

Relating to the Roman Catholic Church, which is led by the Pope and characterized by its global presence and doctrines such as the sacraments and veneration of saints.

Muslim

A follower of Islam, a monotheistic Abrahamic religion based on the Quran, which Muslims believe to be the word of God as told to Muhammad, the final prophet.