25th SMS, A case
CASE SCENARIO ,,, A 36 year man complaining of sudden right side chest pain with shortness of breath, occurred while sitting watching TV. Pain made worse by deep breath & cough. Shortness of breath persisted for 4 hours from onset to arrival to the ER. He has slight nonproductive cough. No relevant past medical history or family history. He works in a bank & returned 3 weeks ago for a holiday in Australia. Takes paracetamol for headaches. Examination: temp. 37.4 C , RR 24/min, JVP raised 3cm, BP 110/64, PR 128/min. Resp. Sys: expansion reduced, percussion & tactile vocal fremitus normal & equal, pleural rub over right lower zone posteriorly, no added sounds, other examination is normal, What is the diagnosis & how to confirm it?