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Small primary spontaneous pneumothorax — RCPSC EM MCQ

Instant feedback + full explanation. One question, done properly.

HardRespiratory emergenciesSmall primary spontaneous pneumothoraxRCPSC EM

A healthy 24-year-old has a 3.6-cm apical primary spontaneous pneumothorax, mild dyspnea, SpO2 98% and normal hemodynamics. What is the most appropriate initial pleural strategy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: BPlace a small-bore catheter for aspiration or one-way-valve management

Explanation lettering: C = shown as A · D = shown as C · A = shown as D

B is correct for a stable primary pneumothorax larger than 3 cm. C is the conservative pathway for smaller, minimally symptomatic disease. D is unnecessarily invasive initially. E is a temporary tension-pneumothorax manoeuvre. A is reserved for selected persistent or recurrent disease.

Reference: Emergency Care BC, Spontaneous Pneumothorax—Management: https://emergencycarebc.ca/clinical_resource/clinical-summary/spontaneous-pneumothorax-management/