A 28-Year-Old Woman Comes to the Urgent Care Center at a Ski

question 892

Multiple Choice

A 28-year-old woman comes to the urgent care center at a ski resort due to frostbite.  She dropped one of her gloves while riding the chairlift and was unable to find it while skiing down the slope.  By the time the patient returned to the resort, she was experiencing numbness and paresthesias in her left hand.  Her medical history is unremarkable, and her only regular medication is an oral contraceptive.  The patient does not smoke and drinks alcohol only on social occasions.  Temperature is 36.7 C (98 F) , blood pressure is 108/65 mm Hg, and pulse is 88/min.  Examination shows stiff, pale skin at the fourth and fifth digits of the left hand.  Vesicles and small bullae are seen at the lateral aspect of the fingertips.  The affected digits show absent light-touch sensation and capillary refill.  Which of the following is the most appropriate next step in management of this patient's injury?

• A)Debridement of devitalized tissue
• B)Infusion of warmed fluids
• C)Oral nifedipine
• D)Rapid rewarming with dry heat
• E)Rapid rewarming with warm water
• F)Thrombolytic therapy

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Definitions:

Germinal

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A professional in psychology who studies the growth and development of humans throughout their lifespan, focusing on physical, cognitive, and social changes.

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