Which respiratory emergency presents with unilateral chest rise and diminished breath sounds on one side, often after coughing or exertion?

• A. Anaphylaxis
• B. COPD
• C. Spontaneous pneumothorax
• D. Delirium

Answer: (C)

A spontaneous pneumothorax is suggested by unilateral chest rise with diminished breath sounds on that side because air has leaked into the pleural space and partially collapses the lung on one side. This rupture often occurs without trauma, sometimes precipitated by activities that increase intrathoracic pressure, such as coughing or exertion. The collapsed lung on the affected side produces reduced or absent breath sounds there and causes the chest to expand unevenly. In a typical spontaneous pneumothorax, you may also hear hyperresonant percussion on the affected side and the patient may experience sudden sharp chest pain and shortness of breath. If it progresses to a tension pneumothorax, signs of life-threatening compromise like hypotension and tracheal deviation can occur, requiring immediate action. The other options don’t fit because anaphylaxis involves airway swelling and systemic symptoms, COPD presents with chronic, usually bilateral changes and a long history rather than an abrupt unilateral finding, and delirium is a mental status change rather than a primary respiratory emergency.