A 23-Year-Old Man Is Brought to the Emergency Department After

question 452

Multiple Choice

A 23-year-old man is brought to the emergency department after a motor vehicle collision.  The patient was found unresponsive at the scene and intubated by the paramedics, who also administered 2 L of normal saline.  He was the unrestrained driver.  Upon arrival, blood pressure is 72/54 mm Hg, and pulse is 120/min.  The patient responds to strong vocal and tactile stimuli by opening his eyes.  Pupils are equal and reactive to light.  Neck veins are distended.  There are multiple bruises involving the anterior chest and upper abdomen.  Chest x-ray reveals a small, left-sided pleural effusion and normal cardiac contours.  Which of the following is the most likely diagnosis?

• A)Aortic rupture
• B)Bronchial rupture
• C)Cardiac tamponade
• D)Esophageal rupture
• E)Lung contusion