A 34-Year-Old Man Is Brought to the Emergency Department After

question 216

Multiple Choice

A 34-year-old man is brought to the emergency department after a motor vehicle collision.  He has blunt abdominal trauma and bilateral femur fractures.  The patient has no significant medical history and takes no medications.  He does not smoke but drinks 8-12 alcoholic beverages a day.  Blood pressure is 80/40 mm Hg and pulse is 110/min.  Immediate resuscitation efforts are initiated, during which he receives transfusion of several units of packed red blood cells.  During transport to the intensive care unit, the patient reports a tingling sensation in his fingers and toes.  Serum ionized calcium level is 4 mg/dL (normal: 4.8-5.5) .  Which of the following is the most likely cause of this patient's current symptoms?

• A)Antibody-mediated red blood cell membrane damage
• B)Calcium chelation by a substance in the transfused blood
• C)Electrolyte leakage from red blood cells during pretransfusion storage
• D)Increased renal tubular excretion of calcium
• E)Release of intracellular contents from injured muscle

---

Definitions:

Recall

The ability to retrieve and access information from one's memory that has been previously learned or experienced.

Spelling

The process or activity of writing or naming the letters of a word in the correct order.

Vocabularies

The set of words that a person knows or uses and the overall language resources available to individuals or communities.

Fluency

The ease and smoothness of speech or writing, often reflecting a person's mastery of a language or ability to express thoughts with clarity.