Professional and Linguistic Assessments Board (PLAB) Practice Exam

For a patient with a symptomatic pneumothorax that is less than 2cm, what is the most appropriate management step?

1. Discharge without treatment

2. Aspirate the pneumothorax

3. Initiate IV antibiotics

4. Oxygen therapy

The correct answer is: Aspirate the pneumothorax

A symptomatic pneumothorax, particularly one that measures less than 2 cm, typically requires intervention due to the patient's symptoms. In such a situation, the most appropriate management step is to aspirate the pneumothorax. This procedure involves using a needle to remove the air that has accumulated in the pleural space, which can help alleviate symptoms and prevent the condition from worsening. When patients demonstrate symptoms, the risk of complications increases, so addressing their condition effectively is crucial. Aspiration can provide immediate relief and is a good first-line treatment option for small, symptomatic pneumothoraces. Other management options presented may not directly address the immediate needs of a symptomatic pneumothorax. Discharge without treatment would not be suitable given that the patient is symptomatic. Initiating IV antibiotics is generally reserved for infected pleural effusions or empyemas rather than pneumothorax unless there is an indication of infection. Oxygen therapy may help reabsorb the pneumothorax more quickly; however, it does not relieve symptoms as effectively or as quickly as aspiration does. Hence, aspiration is the most appropriate choice in this scenario.