THURSDAY´S Question Sample!!!
A 21-year-old college student comes to the emergency department because of a 30-minute history of difficulty in breathing, and a sharp left-sided chest pain that came on suddenly when he was walking back to his dormitory after biology class. He says that he is generally very healthy and has never experienced anything like this in the past. He is 188 cm (6 ft 2 in) tall and weighs 70 kg (154 lb). His temperature is 37.0 C (98.6 F), blood pressure is 120/80 mm Hg, pulse is 75/min, and respirations are 22/min. Physical examination shows decreased breath sounds, decreased tactile fremitus, and increased resonance to percussion on the left side. The cardiac examination is normal. You order a chest x-ray and go to see the next patient. You hear a radiology technician call for help as you finally get to sit down to write your notes. You run over to the patient and find that it is your "shortness of breath
and chest pain" patient and that he has not had the chest x-ray yet. He is now cyanotic and has severe dyspnea. Examination shows tracheal deviation and distended neck veins. The most appropriate immediate management is
A. draw an arterial blood gas
B. endotracheal intubation
C. insert a chest tube on the left side
D. insert a needle into the left 2nd intercostal space
E. obtain a chest x-ray at the bedside
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Mod edit - advertising removed. I've left the questions incase anyone wants to have a stab though.
Last edited by Will Watson; 03-08-2007 at 12:10 PM.
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