A 25-year-old man presents with sudden onset of severe dyspnoea after lifting weights. Chest X-ray shows complete collapse of the left lung with mediastinal shift to the right and a deep left costophrenic angle. Which diagnosis is most likely?
- A Lobar collapse due to mucus plug
- B Large pleural effusion
- C Tension pneumothorax ✓
- D Diaphragmatic hernia
Correct answer: C. Tension pneumothorax
Explanation
Tension pneumothorax shows complete lung collapse, mediastinal shift to the opposite side, and a deep (deep sulcus sign) on the affected side. Pleural effusion shifts mediastinum contralaterally but does not cause complete lung collapse. Lobar collapse shifts mediastinum ipsilaterally. Diaphragmatic hernia shows bowel loops in the chest, not a deep sulcus.
Reference: Chest X-ray Made Easy, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.