12-08-2008, 06:45 AM
sorry vanco but i want u to be confident.
orthop here is explanation for u.
The correct answer is E. The presence of an "acute abdomen," which this woman has,
is an indication for exploratory surgery and prompt repair of the injuries (probably
affecting hollow viscera) that have produced the signs of peritoneal irritation.
Continued clinical observation (choice A) would be irresponsible when it is clinically
obvious that she already has an acute abdomen. What would one observe for?
Development of septic shock? Death?
CT scan (choice B) is ideal when the issue is potential intraabdominal bleeding in a
hemodynamically stable patient who can be safely sent to the radiology department. CT
scan might even be a good idea if the picture of acute abdomen were equivocal. But it is
not needed here.
Diagnostic peritoneal lavage (choice D) or sonogram done in the emergency
department (choice C) are our options when we suspect intraabdominal bleeding and
the patient is too unstable to be sent anywhere. As pointed out above, however, when an
acute abdomen has clearly developed, it is time to operate.
orthop here is explanation for u.
The correct answer is E. The presence of an "acute abdomen," which this woman has,
is an indication for exploratory surgery and prompt repair of the injuries (probably
affecting hollow viscera) that have produced the signs of peritoneal irritation.
Continued clinical observation (choice A) would be irresponsible when it is clinically
obvious that she already has an acute abdomen. What would one observe for?
Development of septic shock? Death?
CT scan (choice B) is ideal when the issue is potential intraabdominal bleeding in a
hemodynamically stable patient who can be safely sent to the radiology department. CT
scan might even be a good idea if the picture of acute abdomen were equivocal. But it is
not needed here.
Diagnostic peritoneal lavage (choice D) or sonogram done in the emergency
department (choice C) are our options when we suspect intraabdominal bleeding and
the patient is too unstable to be sent anywhere. As pointed out above, however, when an
acute abdomen has clearly developed, it is time to operate.