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12 September, 21:49

A 17-year-old high school senior presents to your clinic in acute respiratory distress. between shallow breaths he states he was at home finishing his homework when he suddenly began having right-sided chest pain and severe shortness of breath. he denies any recent traumas or illnesses. his past medical history is unremarkable. he doesn't smoke but drinks several beers on the weekend. he has tried marijuana several times but denies any other illegal drugs. he is an honors student and is on the basketball team. his parents are both in good health. he denies any recent weight gain, weight loss, fever, or night sweats. on examination you see a tall, thin young man in obvious distress. he is diaphoretic and is breathing at a rate of 35 breaths per minute. on auscultation you hear no breath sounds on the right side of his superior chest wall. on percussion he is hyperresonant over the right upper lobe. with palpation he has absent fremitus over the right upper lobe.

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  1. 13 September, 00:32
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    If you asking for the diagnosis, the answer would be spontaneus pneumothorax.

    Pneumothorax is a condition when the membrane (pleura) of the lungs is broken, make the thoracic space exposed to the atmosphere. Thoracic space becomes filled with air, makes the patient felt pain and hard to breathe.

    The air will cause the breath sound reduced, hyperresonant percussion and absent of fremitus. Tall men will be at higher risk since taller height also means taller lungs.
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