Professional and Linguistic Assessments Board (PLAB) Practice Exam

When managing a pneumothorax, what is the appropriate action for an asymptomatic patient with a less than 2cm pneumothorax?

1. Discharge the patient

2. Aspirate the pneumothorax

3. Drill a chest tube

4. Refer for surgery

The correct answer is: Discharge the patient

In the case of an asymptomatic patient presenting with a pneumothorax that measures less than 2 cm, discharging the patient can be deemed appropriate. For small, uncomplicated pneumothoraces, especially when there are no symptoms or significant clinical signs, careful observation is often sufficient. The rationale behind this approach is that many small pneumothoraces can resolve spontaneously without intervention, and the risk of progression to more severe complications is low in asymptomatic patients. Management protocols often involve follow-up to ensure no progression of the pneumothorax and to monitor for the development of symptoms. If, during a follow-up, the pneumothorax remains small and the patient continues to be asymptomatic, further treatment such as aspiration, chest tube insertion, or surgical consultation usually isn’t necessary. The other choices entail actions that are more invasive or unnecessary for the management of a stable and asymptomatic patient. Therefore, discharging the patient with appropriate advice and follow-up instructions is the most suitable course of action in this situation.