Emergency Medical Technician (EMT) Intermediate Practice Exam

A 77-year-old male with a history of emphysema presents with worsening shortness of breath and pleuritic chest pain after a forceful cough. This patient's clinical presentation is MOST consistent with:

1. Pleural effusion

2. Chronic obstructive pulmonary disease exacerbation

3. Spontaneous pneumothorax

4. Asthma attack

The correct answer is: Spontaneous pneumothorax

The clinical presentation of a 77-year-old male with emphysema who experiences worsening shortness of breath and pleuritic chest pain following a forceful cough aligns most closely with spontaneous pneumothorax. In this scenario, the combination of symptoms suggests that the underlying structure of the lung may have been compromised, possibly due to the increased pressure from the cough. Emphysema causes the alveoli to become weak and can predispose individuals to spontaneous pneumothorax, which occurs when air leaks into the pleural space. The pleuritic chest pain indicates irritation or inflammation of the pleura, often experienced when there is an imbalance of air pressure in the chest cavity. While the other choices may present similar symptoms, they do not account for the acute nature of the presentation following the cough as clearly as spontaneous pneumothorax does. A pleural effusion typically presents with dullness to percussion and may not specifically cause pleuritic pain. Chronic obstructive pulmonary disease (COPD) exacerbation can lead to shortness of breath but may be accompanied by other signs like wheezing or increased respiratory effort, rather than acute pleuritic pain. An asthma attack usually involves wheezing and airway obstruction but is less consistent with the specific