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Spontaneous pneumothorax — MCCQE Part 1 MCQ

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EasyDyspneaSpontaneous pneumothoraxMCCQE Part 1

A tall 22-year-old man develops sudden unilateral pleuritic chest pain and shortness of breath at rest; breath sounds are reduced and chest radiograph shows a pleural line. Which of the following is the most likely diagnosis?

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Correct answer: D — Spontaneous pneumothorax

Spontaneous pneumothorax is the single best answer because the age, timing, examination findings and investigations in the vignette fit Spontaneous pneumothorax better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian emergency medicine guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian emergency medicine guidance