Which of the following conditions is most likely to have given rise to these events?
A 20-year-old man falls to the ground while jogging along a city street early one morning. He suffers a minor abrasion to his left hand. However, within minutes he is very dyspneic and has right-sided chest pain. He walks into a nearby store, and the manager calls for an ambulance. On arrival at the hospital, he has tachypnea and tachycardia. On physical examination, breath and sounds are absent over the right lung fields. A chest radiograph shows that the mediastinum is shifted to the left, and there are no fractures. A thoracentesis on the right yields a rush of air.
A. Bronchopleural fistula B. Paraseptal emphysema C. Foreign body aspiration D. Intrinsic asthma E. Pulmonary atherosclerosis
Paraseptal emphysema -b) correct. paraseptal emphysema is not common, but does account for a significant number of cases of spontaneous pneumothorax in young persons. it is not related to smoking. there are subpleural bullae that can burst, even with minimal trauma.(a) incorrect. a bronchopleural fistula typically occurs in the setting of a severe lung infection, not in a healthy person.(e) incorrect. both chronic restrictive and obstructive lung diseases can reduce the pulmonary vascular bed to increase pulmonary arterial pressures that promote pulmonary atherosclerosis. the vessels do not rupture.