Respiratory medicine: primary spontaneous pneumothorax: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Respiratory medicine: primary spontaneous pneumothorax

Sample item

A tall thin 18-year-old has mild pleuritic pain and a small (under 2 cm) apical pneumothorax. He is not breathless and has normal oxygen saturation. What is the best management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Observation with outpatient follow-up

Small, asymptomatic primary spontaneous pneumothoraces often resolve without intervention, and observation with a repeat chest film is appropriate. Larger or symptomatic ones need needle aspiration or a chest drain. Surgery and pleurodesis are considered for recurrence.

Option by option

  • A. Intercostal drain with underwater seal

    A drain is not needed when the patient is stable and the air rim is small.

  • B. Immediate thoracotomy

    Thoracotomy is excessive for a first small event.

  • C. Observation with outpatient follow-up (correct)

    Correct. A small asymptomatic pneumothorax can be observed.

  • D. Immediate chemical pleurodesis

    Pleurodesis is for recurrent episodes.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Observation with outpatient follow-up. Small, asymptomatic primary spontaneous pneumothoraces often resolve without intervention, and observation with a repeat chest film is appropriate.

Why is "Intercostal drain with underwater seal" not the answer?

A drain is not needed when the patient is stable and the air rim is small.

Why is "Immediate thoracotomy" not the answer?

Thoracotomy is excessive for a first small event.

Why is "Immediate chemical pleurodesis" not the answer?

Pleurodesis is for recurrent episodes.

What concept does this question test?

It tests Respiratory medicine: primary spontaneous pneumothorax in General Medicine. Larger or symptomatic ones need needle aspiration or a chest drain. Surgery and pleurodesis are considered for recurrence.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory medicine: primary spontaneous pneumothorax?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.