USMLEGladiator
2009 & still in race
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5. Twenty-four hours after splenectomy for blunt trauma sustained in a motor vehicle collision, a previously healthy 25-year-old man has oliguria and pain at the incision site. Intraoperative complications included a 30-minute period of hypotension and a total blood loss of 2.5 L requiring 4 units of packed red blood cells. Currently, his temperature is 38°C (100.4°F), blood pressure is 120180 mm Hg, pulse is 1001min, and respirations are 14/min. Central venous pressure is 8 cm H 2O (N=5-8). The lungs are clear to auscultation, and breath sounds are heard bilaterally. Abdominal examination shows no distention, bowel sounds are absent. A Foley catheter is in place, and over the past 3 hours, his urine output has been 20 mL/h. Laboratory studies show a hematocrit of 28%, a serum urea nitrogen (BUN) level of 30 mg1dL, and a serum creatinine level of 2.5 mgfdL, serum electrolyte levels are within normal limits. Which of the following is the most likely explanation for these findings?
O A) Acute tubular necrosis
O B) Foley catheter malfunction
O C) Hypervolemia
O D) Transfusion reaction
0 E) Ureteral injury
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| Aashi
Forum Moderator
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A) Acute tubular necrosis
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"Obstacles are those frightful things you see when you take your EYES off your goal."
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| USMLEGladiator
2009 & still in race
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what is significance of incrd CVP?
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| Tuscani
Forum Guru
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why not foley catheter malfunction?
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