A 23-year-old woman is brought to the emergency department 2 hours after the sudden onset of shortness of breath and pleuritic chest pain. She has cystic fibrosis and, during the past year, has had 4 respiratory exacerbations that have required hospitalization. Current medications include an inhaled bronchodilator, an inhaled corticosteroid, inhaled N-acetylcysteine, and azithromycin. 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?

Question

A 23-year-old woman is brought to the emergency department 2 hours after the sudden onset of shortness of breath and pleuritic chest pain. She has cystic fibrosis and, during the past year, has had 4 respiratory exacerbations that have required hospitalization. Current medications include an inhaled bronchodilator, an inhaled corticosteroid, inhaled N-acetylcysteine, and azithromycin. 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?

Quizplus · Accepted Answer

Eductional Objective: Primary spontaneous pneumothorax occurs in patients without preexisting pulmonary disease when a large change in the alveolar or intrapleural pressure results in a break in the visceral (eg, ruptured superficial bleb) pleura and air trapping between the pleural spaces.

A 23-Year-Old Woman Is Brought to the Emergency Department 2