Medicine

A 72-year-old man with COPD develops acute shortness of breath and presents to the hospital. He appears uncomfortable: blood pressure is 120/90 mmHg, pulse 100/min, oxygen saturation 85% on room air. On examination of the chest, there is absent fremitus, absent breath sounds, and hyperresonant percussion of the right lung. The trachea is shifted to the left.For the above patient with abnormal pulmonary physical findings, select the most likely diagnosis.