respiratory case - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 09-10-2012
K06100's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 730
Threads: 90
Thanked 456 Times in 289 Posts
Reputation: 466
Default respiratory case

A 14-year-old boy is hit by an automobile while walking across the street and is immediately taken to the emergency department. On arrival, he is conscious and complains of shortness of breath and chest pain. Physical examination reveals an ecchymotic area over his right chest and subcutaneous emphysema. Breath sounds are absent on the right side. His trachea is deviated to the left, and his right hemithorax is tympanic to percussion. Which of the following is the most appropriate initial step in management of this patient?

a)12-lead ECG
b)CT of the chest
c)Plain radiography of the chest
d)Chest tube thoracostomy
e) Pericardiocentesis
__________________
Try Not To Become A Man Of Success But A Man Of Value.
Reply With Quote Quick reply to this message



  #2  
Old 09-10-2012
XpaezX's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,216
Threads: 41
Thanked 1,327 Times in 711 Posts
Reputation: 1342
Default

D
he is in the way of developing tension pneumothorax
Reply With Quote Quick reply to this message
  #3  
Old 09-10-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,867
Threads: 149
Thanked 2,104 Times in 1,049 Posts
Reputation: 2124
Default

d)Chest tube thoracostomy
__________________
A man doesn't know what he knows until he knows what he doesn't know.
“What is man? He's just a collection of chemicals with delusions of grandeur.”
Reply With Quote Quick reply to this message
 
  #4  
Old 09-10-2012
Hitman's Avatar
USMLE Forums Master
 
Steps History: Not yet
Posts: 928
Threads: 17
Thanked 539 Times in 375 Posts
Reputation: 549
Default

yes D....
Reply With Quote Quick reply to this message
  #5  
Old 09-10-2012
K06100's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 730
Threads: 90
Thanked 456 Times in 289 Posts
Reputation: 466
Default

The correct answer is D....
. The findings on physical examination strongly suggest tension pneumothorax. This is a life-threatening emergency that needs to be managed immediately with either chest tube thoracostomy or needle thoracocentesis to relieve the tension on the affected side of the thorax. Physical examination reveals tachycardia, tachypnea, decreased or absent breath sounds over the involved hemithorax, increased resonance to percussion, subcutaneous emphysema, and deviation of the trachea to the opposite side. Tension pneumothorax develops when air leaking into the chest increases intrathoracic pressure, completely collapsing the lung on that side. It results in displacement of the mediastinum and trachea to the opposite side of the chest and impedes venous return. 12-lead ECG (choice A), CT of the chest (choice C), and plain radiography of the chest (choice E) may be indicated on a trauma patient after the patient is stabilized. In tension pneumothorax, no imaging study should precede the emergent relief of tension inside the chest. Pericardiocentesis (choice D) is indicated when there is cardiac tamponade, caused by build-up of fluid in the pericardium. Cardiac tamponade significantly affects ventricular relaxation and markedly decreases cardiac output
__________________
Try Not To Become A Man Of Success But A Man Of Value.
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Respiratory epithelium heman466s USMLE Step 1 Forum 5 10-24-2011 11:30 AM
Respiratory changes in pregnency? Ace3 USMLE Step 2 CK Forum 2 10-19-2011 04:44 AM
Respiratory alkalosis jahn77 USMLE Step 1 Forum 7 07-12-2011 06:20 AM
What is your diagnosis? (Respiratory) aktorque USMLE Step 1 Forum 11 05-30-2011 02:43 PM
respiratory pathology ecgram USMLE Step 1 Forum 3 05-22-2010 12:21 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)