skip to main content

Tension pneumothorax — USMLE Step 3 MCQ

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

HardEmergency MedicineTension pneumothoraxUSMLE Step 3

A 19-year-old man is brought to the emergency department after a motorcycle crash. He is hypotensive despite 2 L of crystalloid. Breath sounds are absent on the left, trachea is deviated to the right, neck veins are distended, and oxygen saturation is 84% despite oxygen. Which of the following is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: A — Tension pneumothorax

Hypotension, unilateral absent breath sounds, tracheal deviation, distended neck veins, and hypoxemia after trauma are classic for tension pneumothorax, requiring immediate decompression before confirmatory imaging.

Reference: ATLS trauma guidance