Can You Interpret This Chest X-Ray & Correctly Manage the Condition?

Welcome to the next episode of The Reveal where we take you inside the mind of a test-taker to deconstruct and connect the dots of a board-style question so you can become a better student, transform how you learn, and excel not only on high-stakes exams, but also in your general medical knowledge. Let’s get started.

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A 22-year-old healthy man presents with acute onset pleuritic, left-sided chest pain and mild dyspnea. Social history includes smoking a pack of cigarettes a week. Vital signs include blood pressure 142/74 mm Hg, heart rate 82 beats/minute, and oxygen saturation 97% on room air. He is in no acute distress. His chest radiograph is shown above. Which of the following is the next best step in management?

A) Discharge home with ibuprofen for pain relief

B) Order a computed tomography scan of the chest

C) Perform a chest tube thoracostomy

D) Place patient on 100% oxygen and repeat chest radiograph in six hours

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