A 25-Year-Old Man Is Brought to the Emergency Department After

question 52

Multiple Choice

A 25-year-old man is brought to the emergency department after he fell headfirst down a flight of stairs while intoxicated.  According to friends who witnessed the fall, the patient landed on his head but did not lose consciousness.  On arrival, blood pressure is 128/78 mm Hg, pulse is 92/min, and respirations are 12/min.  The patient smells of alcohol and is somnolent but can follow simple commands.  There are facial abrasions.  A rigid cervical collar is in place.  Bilateral breath sounds are normal with no chest tenderness.  Heart sounds are normal.  The abdomen is soft and nontender.  The patient is moving all extremities spontaneously.  He states that he is uncomfortable due to the cervical collar and requests that it be removed.  Which of the following is the best immediate step for evaluating and ruling out cervical spine injury in this patient?

• A)CT scan without contrast
• B)Flexion and extension x-rays
• C)MR imaging without contrast
• D)Portable lateral x-ray
• E)Thorough neurologic examination

---

Definitions:

Antitrust Issues

Legal matters related to laws that prevent monopolies and promote competition among businesses.

Asia-Pacific

A region in the Western Pacific comprising East Asia, South Asia, Southeast Asia, and Oceania.

Free-Market Economy

An economic system where prices for goods and services are determined by the open market and consumers, with minimal government intervention.

Capitalism

An economic system characterized by private or corporate ownership of capital goods, investments determined by private decision, and prices, production, and the distribution of goods that are determined mainly by competition in a free market.