A 55-Year-Old Man Is Brought to the Emergency Department After

question 379

Multiple Choice

A 55-year-old man is brought to the emergency department after falling from a 20-ft (6.2-m) height.  The patient was leaning over a second-story roof to hang Christmas lights when he lost his footing and fell forward.  Although he partially braced his fall with outstretched arms and legs, his body hit the pavement with full force.  The patient has severe chest and back pain.  Blood pressure is 162/90 mm Hg in the left arm, pulse is 118/min, and respirations are 24/min.  On physical examination, the patient is alert but appears scared.  His voice is hoarse when he tries to speak.  The pupils are symmetric and reactive to light, and the trachea is midline.  There is bruising over the sternum, which is tender to palpation.  Breath sounds are symmetric bilaterally, and heart sounds are normal with no murmurs.  The abdomen is soft and nontender.  There are superficial abrasions on the patient's palms and knees.  The lower extremities are cool to touch with diminished femoral pulses bilaterally.  Which of the following is most likely to confirm the diagnosis in this patient?

• A)Chest tube placement
• B)CT angiography of the chest
• C)Esophagography
• D)Flexible bronchoscopy
• E)Pericardiocentesis
• F)Transthoracic echocardiography

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Definitions:

Intrinsic Motivation

Intrinsic motivation refers to the drive to engage in an activity for its own sake, derived from personal satisfaction or interest, rather than external rewards.

Reinforcement Value

The subjective importance or appeal of the potential outcome that influences the likelihood of a behavior's occurrence.

Anorexia Nervosa

An eating disorder characterized by an obsessive fear of gaining weight, leading to restricted food intake and extreme thinness.

Fructose

Fructose is a simple sugar found in many plants that is sweeter than glucose and used in foods and beverages as a sweetener.