A 23-year-old man comes to the emergency department reporting right-sided chest pain that began abruptly 3 hours earlier. He is otherwise healthy, but has a 7 pack-year history of smoking. Temperature is 36.5 deg * C (97.7 deg * F) pulse is 135 / m * in and respirations are 25 / m * in and blood pressure is 100/60 mm Hg. The patient is 180 cm (5 ft 11 in) tall and weighs 59.5 kg (131 lb); body mass index is 18.3kg / m * 2 On physical examination, the patient is in visible respiratory distress. Hyperresonance, decreased breath sounds, and decreased tactile fremitus are noted in the right lower lung field. Which of the following is the most likely diagnosis?

a. Pulmonary embolism

b. Tension pneumothorax

Oc. Emphysema

d. Asthma

Oe. Rupture of a pleural bleb

Of Bronchiectasis

