Question:easy
An otherwise healthy young man presented with sudden onset of breathlessness which was increasing rapidly. On examination, it was found that the left chest movement was grossly restricted, breath sounds were absent, and the percussion note was tympanitic. The most likely diagnosis is
An otherwise healthy young man presented with sudden onset of breathlessness which was increasing rapidly. On examination, it was found that the left chest movement was grossly restricted, breath sounds were absent, and the percussion note was tympanitic. The most likely diagnosis is
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Rapidly worsening breathlessness with a silent, tympanitic hemithorax points to a building pressure, not just trapped air.
Updated On: Jul 7, 2026
- Tension pneumothorax
- Simple pneumothorax
- Bronchial asthma
- Cardiac asthma
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The Correct Option is A
Solution and Explanation
Step 1: List what the exam tells us.
A young healthy man suddenly cannot breathe, and it is getting worse fast. One side of his chest barely moves, has no breath sounds, and sounds hollow, like a drum, when tapped.
Step 2: Work out what a hollow, drum-like note means.
A tympanitic note over the chest means air has collected where lung tissue should be, pushing the lung away from the chest wall. This is a pneumothorax.
Step 3: Decide why it is getting worse so fast.
A simple pneumothorax lets in a fixed amount of air and usually stays fairly stable. Here the breathlessness is climbing quickly, which fits a one-way air leak: air gets pumped into the pleural space on every breath in but cannot escape on breathing out. Pressure keeps rising, squashing the lung harder and shifting the mediastinum, and this rapid, escalating picture is the hallmark of tension pneumothorax.
Step 4: Rule out the medical causes.
Bronchial asthma gives wheeze and prolonged expiration over both lungs, not one silent hollow-sounding side. Cardiac asthma comes from heart failure with crackles and wheeze, again bilateral, not a single collapsed, air-filled hemithorax.
Step 5: Conclude.
The presentation matches tension pneumothorax.
\[ \boxed{\text{Tension pneumothorax}} \]
A young healthy man suddenly cannot breathe, and it is getting worse fast. One side of his chest barely moves, has no breath sounds, and sounds hollow, like a drum, when tapped.
Step 2: Work out what a hollow, drum-like note means.
A tympanitic note over the chest means air has collected where lung tissue should be, pushing the lung away from the chest wall. This is a pneumothorax.
Step 3: Decide why it is getting worse so fast.
A simple pneumothorax lets in a fixed amount of air and usually stays fairly stable. Here the breathlessness is climbing quickly, which fits a one-way air leak: air gets pumped into the pleural space on every breath in but cannot escape on breathing out. Pressure keeps rising, squashing the lung harder and shifting the mediastinum, and this rapid, escalating picture is the hallmark of tension pneumothorax.
Step 4: Rule out the medical causes.
Bronchial asthma gives wheeze and prolonged expiration over both lungs, not one silent hollow-sounding side. Cardiac asthma comes from heart failure with crackles and wheeze, again bilateral, not a single collapsed, air-filled hemithorax.
Step 5: Conclude.
The presentation matches tension pneumothorax.
\[ \boxed{\text{Tension pneumothorax}} \]
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