USMLE Forum Archives - USMLE Step 2 CK - surgery
surgery
HIV - 12-31-07 12:47
On the 7th postoperative day after the pinning of a broken hip, a 76-year-old man suddenly develops severe pleuritic chest pain and shortness of breath. When examined, he is found to be anxious, diaphoretic, and tachycardic, with a blood pressure of 140/85 mm Hg. He has prominent distended veins in his neck and forehead. Blood gases show hypoxemia and hypocapnia. His chest x-ray film is unremarkable. The nurses have placed him on supplemental oxygen by face mask. Which of the following is the most appropriate next step in management?
A. Aortogram and emergency surgical repair
B. ECG and cardiac enzymes
C. Intubation and respirator, with hyperventilation and PEEP
D. Retinal examination looking for fat droplets
E. Ventilation-perfusion lung scan, or spiral CT scan of the chest
HIV - 12-31-07 12:47
On the 7th postoperative day after the pinning of a broken hip, a 76-year-old man suddenly develops severe pleuritic chest pain and shortness of breath. When examined, he is found to be anxious, diaphoretic, and tachycardic, with a blood pressure of 140/85 mm Hg. He has prominent distended veins in his neck and forehead. Blood gases show hypoxemia and hypocapnia. His chest x-ray film is unremarkable. The nurses have placed him on supplemental oxygen by face mask. Which of the following is the most appropriate next step in management?
A. Aortogram and emergency surgical repair
B. ECG and cardiac enzymes
C. Intubation and respirator, with hyperventilation and PEEP
D. Retinal examination looking for fat droplets
E. Ventilation-perfusion lung scan, or spiral CT scan of the chest
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