Intensive Care Medicine (ICM) Practice Exam

What symptom would likely NOT be present in a case of pneumothorax?

1. Hyperresonance upon percussion

2. Decreased breath sounds

3. Increased fremitus

4. Asymmetrical chest expansion

The correct answer is: Increased fremitus

In the context of a pneumothorax, increased fremitus is not typically associated with this condition. Fremitus refers to the vibration transmitted through lung tissues when a person speaks, which can be felt during palpation of the chest wall. In cases of pneumothorax, there is an accumulation of air in the pleural space, creating a barrier that diminishes the transmission of vibrations. As a result, the fremitus is usually decreased over the affected area rather than increased. On the other hand, hyperresonance upon percussion is commonly observed in pneumothorax due to the presence of excess air in the pleural cavity, leading to a sound that is more resonant than normal lung tissue. Decreased breath sounds are expected because the air in the pleural space obstructs the normal airflow and sound transmission through the affected lung. Additionally, asymmetrical chest expansion may occur, as the side with the pneumothorax may not expand normally during inhalation due to the presence of air in the pleural space, while the other side continues to function normally.