Pneumothorax

A 35-year-old woman with a history of COPD presents with acute shortness of breath and pleuritic chest pain. On examination, she has decreased breath sounds on the right side and hyperresonance to percussion. Her observations are: heart rate 105 bpm, respiratory rate 28 breaths per minute, blood pressure 130/85 mmHg, and oxygen saturation 92% on room air.

Which investigation is the gold standard for confirming the diagnosis?

A 40-year-old man with a history of asthma presents with sudden onset of breathlessness and pleuritic chest pain. He has a known history of severe asthma exacerbations. On examination, he has decreased breath sounds on the right side. His observations are: heart rate 95 bpm, respiratory rate 22 breaths per minute, blood pressure 135/85 mmHg, and oxygen saturation 94% on room air. A chest X-ray confirms the presence of a right-sided pneumothorax.

What is the initial management step for this patient?

A 55-year-old woman with a history of smoking presents with sudden onset of left-sided chest pain and dyspnea. She is diagnosed with a large left-sided pneumothorax and is treated with chest tube insertion. She has a smoking history and mild emphysema.

Which factor is most indicative of a poor prognosis in pneumothorax?

A 40-year-old man presents with sudden onset of right-sided chest pain and dyspnea after a fall. On examination, he has decreased breath sounds and hyperresonance on the right side. A chest X-ray confirms a moderate right-sided pneumothorax.

What is the most appropriate initial management for this patient?

A 22-year-old man presents to the emergency department with sudden onset of sharp, left-sided chest pain and shortness of breath. He has no significant past medical history and is otherwise healthy. He is a non-smoker. On examination, he has reduced breath sounds on the left side, and his trachea is midline. His observations are: heart rate 110 bpm, respiratory rate 24 breaths per minute, blood pressure 125/80 mmHg, and oxygen saturation 96% on room air.

What is the most likely diagnosis?