+- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com)
+-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1)
+--- Forum: Step 2 CK (https://www.usmleforum.com/forumdisplay.php?fid=3)
+--- Thread: nmbe - usmleicandoit (/showthread.php?tid=150123)
nmbe - usmleicandoit - ArchivalUser - 01-05-2007
a 32 yr old man is brought to the emergency dept 30 mins after being involved in a motor vehicle collision. he was the restrained driver. on arrival he is short of breath. his bp is 80/50, pulse is 130/min and r=30/minute. exam shows jvd and abrasions over the left hemithorax. the trachea is deviated to the right. breath sounds are absent on the left.
which of the following is the most likely cause of hypotention?
a) cardiogenic shock
b) congestive heart failure
c) decreased systemic vascular resistance
d) decreased venous return
e) hypovolemic hypoperfusion
f) increased systemic vascular resistance
0 - ArchivalUser - 01-05-2007
e?
0 - ArchivalUser - 01-05-2007
this is tension pneumo
so answer is a ?
0 - ArchivalUser - 01-05-2007
It is tension pneumothorax, causing compression of the large vessels and compromising venous return. So answer is D.
Cardiogenic shock means very low BP because of intrinsic problems with the heart, such as AMI or myocarditis. The heart is not the problem in this scenario.
0 - ArchivalUser - 01-05-2007
agree d
decrease in venous return.
0 - ArchivalUser - 01-05-2007
yup, d