Hypoxemia + Confusion + Petechiae - USMLE Forums
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USMLE Step 2 CK Classic Clues Classic clues seen in clinical case scenarios in USMLE Step 2 CK questions.

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Old 03-25-2010
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Lungs Hypoxemia + Confusion + Petechiae

The triad of hypoxemia (dyspnea) and confusion (disorientation and depressed consciosness) and Petechiae is classic for pulmonary fat embolism.

In real life (therefore in USMLE questions) the main differential is Adult Respiratory Distress Syndrome ARDS. Because both of them usually presents few days after the setting of a major trauma that may involve bony fractures.

However, classically the development of petichiae specially in the neck or axilla should makes us choose the fat embolism as the answer.

In ARDS you get other clues such as unresponsive to Oxygen and ground glass lung fields in X rays.

It's important to remember that unlike the usual thromboembolic pulmonary embolism we don't anticoagulate patients with fat embolism.
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Internal-Medicine-, Pulmonology-

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