study_ing
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pt underwent Femoral fracture.
post op day 3. complains of SOB.
bilateral basilar crackles, high CVP and s 3 present.
what is the most likely coz of the syptoms?
name one parameter ure gonna check specifically for in the pt's record.
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| study_ing
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pul edema due to OVERHYDRATION!
check for urinary output..may be way mor than 2 litres
reemember PE duz not present with pul edema so dont be mislead by the SOB and femoral fracture.
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| tolito
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oh yeah. i was initially thinking of fat embolism but then i noticed the S3 . goljan says that is from high fluid load in the ventricle. and then the raised JVP too
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| som
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nice point , to be frank the 1st thing tht hit my mind is PE
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| tolito
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but PE does not occur until after day 7 post op
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| som
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yeah
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| study_ing
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well thats y i posted the qs...i thought PE first and foremost too..good luck and console urselfwith the thought..
'great minds think alike'
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| study_ing
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fat embolism ( rather than clot.) cud occur earlier after a fracture i think...
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| tolito
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| tolito
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as an aside, i know fat embolism inside out cos it killed 2 people i can never forget.
one was a friend's brother 
second was a patient ( a member of staff)
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