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A 19-year-old female presents with sudden, severe right-sided chest pain that developed shortly after she had been placing heavy boxes on shelves in her garage. Physical examination reveals an afebrile female in mild respiratory distress. Breath sounds are markedly decreased on the right, and the right lung is hyperresonant to percussion. Which one of the following is most likely present in this individual?

a. Pneumoconiosis
b. Pneumocystis infection
c. Bacterial pneumonia
d. Viral pneumonia
e. Pneumothorax
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e. Pneumothorax

(Cotran, p 751.) Pneumothorax refers to the accumulation of air in the pleural cavity. Types of pneumothorax include spontaneous pneumothorax, traumatic pneumothorax, and therapeutic pneumothorax. Spontaneous pneumothorax is most commonly associated with emphysema, asthma, and tuberculosis. One special type, however, is idiopathic spontaneous pneumothorax, which occurs primarily in young people. This disorder results from rupture of subpleural blebs. These blebs are most often located in the apex of the lung, and rupture is usually related to stretching or raising the arms. Recurrence of idiopathic spontaneous pneumothorax is common.