question

Prep for USMLE Forum

» Log in | Register

Forum

Step 1

Match

Prep4USMLE Forum » USMLE Step 2 CK Forum » Internal Medicine Forum

question

Author

14 Posts

guangyu
Forum Elite

Topics: 29
Posts: 308

10/31/07 - 03:29 PM

A 36-year-old man develops rapid mental status deterioration two days after sustaining a femoral fracture in a skiing accident. Physical examination shows multiple petechiae in the anterior chest and abdomen. On the third day, the patient lapses into coma and dies. Postmortem examination of the brain reveals numerous petechial hemorrhages in the corpus callosum and centrum semiovale. Which of the following is the most likely diagnosis?
A. Diffuse axonal injury
B. Fat embolism
C. Septic embolism
D. Systemic thromboembolism
E. Watershed infarction

ccan embolism go to brain?

doc_clotaire
Forum Guru
avatar

Topics: 159
Posts: 1,245

10/31/07 - 04:40 PM

B. Fat embolism

___________________
The elevator to succes is broke ,you must take the stairs

MAGY17
Forum Elite
avatar

Topics: 30
Posts: 234

10/31/07 - 06:23 PM

guangyu
Forum Elite

Topics: 29
Posts: 308

11/01/07 - 11:30 AM

my real question is can embolism go to brain from femoral?

ing
Forum Guru
avatar

Topics: 45
Posts: 435

11/02/07 - 10:43 AM

Why not A?
embolism go to brain from femoral when he has VSD.

___________________
Never give up!!

drshvetasm
Forum Elite

Topics: 22
Posts: 282

11/02/07 - 01:04 PM

it shud be fat embolism..and the changes described in the brain might be consistent with asphyxia due to it...i think smiling face

darkhorse
Forum Elite
avatar

Topics: 56
Posts: 275

11/02/07 - 06:00 PM

FAT EMBOLISM

___________________
When going gets tough, the tough gets going

neuroblastoma
Forum Guru
avatar

Topics: 100
Posts: 1,018

11/02/07 - 08:49 PM

ing wrote:
Why not A?
embolism go to brain from femoral when he has VSD.

Diffuse Ax Injury results in instantaneous loss of consciousness, and most patients (>90%) remain in a persistent vegetative state

SO ,IN QUES HE DETERIORATES AFTER 2 DAYS---SO,ITS FAT EMBOLI.

dr.wad
Forum Senior
avatar

Topics: 3
Posts: 335

11/02/07 - 08:52 PM

fat embolism

Ivonne
Forum Guru
avatar

Topics: 55
Posts: 1,452

01/28/08 - 11:01 PM

#10

ing wrote:
Why not A?
embolism go to brain from femoral when he has VSD.

In fat embolism neurologic findings are seen in patients without foramen ovale or VSDs.

I found more easy to differenciate from diffuse axonal injury paying attention to the timing:

In fat embolism the acute deterioration of the mental status is up to a week after a long bone fracture.

In diffuse axonal injury (DAI), if the head injury is extensive enough to cause DAI, then altered consciousness should be preset from the beginning.

___________________
If you beleive you can do it then you WILL DO IT!! (by Mymeghhi)

khiladi
Forum Newbie

Topics: 9
Posts: 13

01/29/08 - 08:12 PM

#11

how do you treat fat embolism?

Ivonne
Forum Guru
avatar

Topics: 55
Posts: 1,452

01/29/08 - 08:23 PM

#12

http://www.emedicine.com/med/TOPIC652.HTM#section...

You will have complete info there. Have fun!

___________________
If you beleive you can do it then you WILL DO IT!! (by Mymeghhi)

SmokyWaters
Forum Elite

Topics: 6
Posts: 458

01/30/08 - 07:21 AM

#13

fat embolism

inkspot
Forum Guru
avatar

Topics: 26
Posts: 559

02/03/08 - 12:27 AM

#14

basically it is FAT embolism leading to DIC

DIC causes bleeding in CNS and on chest as in this scenario : )

___________________
Aagae Aagae Dekho hota hai kiya !!!

You don't have permission to post.