Friday, March 26, 2010

I can't breathe!

A teenage male is brought into the ER with complaints of shortness of breath and chest pain that started two days ago. The shortness is mild but gets worse on exertion. The patient presents with peuritic chest pain on the left said described as sharp in nature. He claims this has never happened before.

He denis illicit drugs and any history of trauma. He has no signifcant past medical or surgical history. His family history is non-contributory as well.

The patient presents as slightly hypotensive (112/70), HR- 96, temp- 98.6 F, RR 20, and pulse ox of 94. He is in mild distress and the HENT exam is unremarchable. Trachaea is midline and there are no breath sounds on the left side with hyperresonance on percussion. Abdomen has no remarkable findings. The Xray comes back and is shown below:


What is the differential?
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1 comment:

  1. 2.B.A.DOMarch 28, 2010 at 4:52 PM

    Based on the clinical presentation and graph, the condition is most likely a spontaneous pneumothorax. One must rule other lung conditions like hemathorax, cystic fibrosis, COPD and pneumonia.

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