Which condition presents with sharp chest pain, dyspnea, and sudden onset?

• A. Pulmonary Embolus
• B. Tension pneumothorax
• C. RSV
• D. Tuberculosis

Answer: (A)

Pleuritic chest pain with sudden dyspnea points to an acute obstruction of the pulmonary circulation. A pulmonary embolism fits this pattern: a clot travels to the lungs and abruptly blocks a pulmonary artery, causing a rapid ventilation–perfusion mismatch. That mismatch leads to sudden shortness of breath and sharp, worsened-with-inspiration chest pain. Patients may also be tachycardic and hypoxemic, and in larger emboli can become lightheaded or faint.

Tension pneumothorax can also present suddenly with chest pain and dyspnea, but it usually comes with distinctive exam findings: decreased or absent breath sounds on one side, hyperresonance to percussion, and often signs of shock or neck vein distention. RSV and tuberculosis do not typically present with this abrupt, pleuritic chest pain and sudden dyspnea pattern; RSV is more of a viral, upper-airway illness with cough and wheeze, while TB tends to develop gradually with chronic cough, night sweats, and weight loss.

So the presentation described best matches a pulmonary embolism.