elitoki
Forum Guru
Topics: 54
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a 40y/o man is brought to the ED 1 hr after a high speed motor vehiclecollision. On arrivel, he is awake and alert but has severe pain over the sternum. his systolic BP is 80, pulse 80, rep 10/min. ECG shows multifocal premature ventricular contractions but no ST segment changes. His PO2 is 100mmHg, after 1 lt of lactated ringer's solution is administered, his PO2 decreases to 60mmHg while breathing 4 L/min oxygen by nasal cannula. PCWP has increased from 14 mmHg to 24 mmHg (n1-10) which of the following is the most likely explanation for the patient's poor response to fluid resuscitation?
a) inadeq administ of fluids
b) myocardial contusion
c) MI
d) Pulmonary contusion
e) traumatic rupture of the aorta.
b or c? how differentiate?
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| kpmle2
Forum Elite
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Posts: 292
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b) myocardial contusion
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| dermatology
Forum Elite
Topics: 30
Posts: 293
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confused between A and B .... leaning towards B
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| Justice
Forum Fanatic
Topics: 100
Posts: 1,922
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b) myocardial contusion
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| dermatology
Forum Elite
Topics: 30
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doesnt heart contusion show st elevation ??????
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| peraspera
Forum Elite
Topics: 38
Posts: 233
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Why is't it traumatic rupture of the aorta??
Dr Pestana ( surgery )says in his lecture :any exam case tells, there is injury of
1. sternum
2. the first rib
3. scapula
look it's enormous trauma-we need to lok for traumatic rupture of aorta. Because there are 3 bones in the chest that hard to break.
This man has severe pain over the sternum.
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| tamerbashir
Forum Elite
Topics: 20
Posts: 284
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B C HAVE ST SEGMENT CHANGES
E CAN'T EXPLAIN HIGH PCWP I THINK
I GO WITH A ? NOT SURE
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| chemamr
Moderator and PGY2
Topics: 703
Posts: 4,442
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b?
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