sandra
Forum Guru
Topics: 200
Posts: 468
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3. A 40-year-old man is brought to the emergency department 1 hour after a high-speed motor
vehicle collision. On arrival, he is awake and alert but has severe pain over the sternum. His systolic
blood pressure is 80 mm Hg, pulse is 80/min, and respirations are 10/min. An ECG shows multifocal
premature ventricular contractions but no ST-segment changes. His PO2 is 100 mm Hg. After 1 L of
lactated Ringer's solution is administered, his PO2 decreases to 60 mm Hg while breathing 4 L/min
of oxygen by nasal cannula. Pulmonary capillary wedge pressure has increased from 14 mm Hg to
24 mm Hg (N=1–10). Which of the following is the most likely explanation for the patient's poor
response to fluid resuscitation?
A ) Inadequate administration of fluids
B ) Myocardial contusion
C ) Myocardial infarction
D ) Pulmonary contusion
E ) Traumatic rupture of the aorta
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| Korotkoff
Forum Senior
Topics: 15
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Isn't this thing E?
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| sherry39
Forum Junior
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dddddd..aggravate wid fluids
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| farnsworth
Forum Newbie
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Posts: 165
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B - myocardial contusion
(premature ventricular contractions, signs of left ventricular failure, decreased PaO2 secondary to pulmonary edema)
pulmonar contusion needs a couple of hours (to days) to fully develop.
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| guangyu
Forum Elite
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agree, it is B
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| drseng
Forum Newbie
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_BBB. myocardial contusion
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| Vietnamese
Forum Elite
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Posts: 285
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B
Confuse B and E.
If 2-3 liters had bolus offered, then positive inotrope would have improved hemodynamic. That was fair for cardiac contusion.
Other ideas please !
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