Pneumothorax: The Daily PANCE Blueprint

The answer is D. Primary spontaneous pneumothorax

The patient’s presentation of sudden onset chest pain and dyspnea, coupled with the finding of a pneumothorax in a tall, thin young man without underlying lung disease, is characteristic of a primary spontaneous pneumothorax. This condition often occurs in individuals who fit this demographic profile and is thought to be due to the spontaneous rupture of subpleural apical blebs or bullae.

Explanation for Incorrect Answers:

A. Traumatic pneumothorax due to chest injury: This is less likely in the absence of a history of trauma or chest injury.

B. Iatrogenic pneumothorax following a medical procedure: This type of pneumothorax typically occurs as a complication of medical procedures like thoracentesis or central venous catheter placement, which is not reported in this patient’s history.

C. Secondary spontaneous pneumothorax due to underlying lung disease: Secondary spontaneous pneumothorax occurs in patients with pre-existing lung diseases such as COPD, cystic fibrosis, or lung infections. The patient’s lack of medical history and young age make this etiology less likely.

E. Tension pneumothorax secondary to mechanical ventilation: Tension pneumothorax is a life-threatening condition that often occurs in mechanically ventilated patients or as a complication of a traumatic pneumothorax. This patient’s presentation does not suggest mechanical ventilation or trauma.