A 44-Year-Old Man Is Brought to the Emergency Department After

question 221

Multiple Choice

A 44-year-old man is brought to the emergency department after he was found unresponsive at the scene of a high-speed motor vehicle collision.  The paramedics report that that he was the unrestrained driver, and the passenger in his car was pronounced dead at the scene.  The patient was intubated and rushed to the hospital.  On arrival, his blood pressure is 78/40 mm Hg, pulse is 135/min, and pulse oximetry is 96% on mechanical ventilation with 40% oxygen.  Rapid infusion of isotonic fluids is initiated.  Trauma primary survey reveals an intubated man with appropriate spinal precautions.  There is bruising and the imprint of the steering wheel across the anterior chest.  The trachea is midline, and breath sounds are clear on the right but diminished on the left.  Neck veins are collapsed bilaterally.  Heart sounds are normal.  All four extremities are pale and cool to the touch.  There is no obvious external hemorrhage.  Portable chest x-ray shows multiple rib fractures, opacification of the left hemithorax, and a widened mediastinum.  ECG shows sinus tachycardia.  Which of the following is the most likely diagnosis?

• A)Bronchial rupture
• B)Diaphragmatic rupture
• C)Esophageal rupture
• D)Myocardial contusion
• E)Myocardial rupture
• F)Neurogenic shock
• G)Thoracic aortic injury

Understand how social networking sites maintain user engagement and marketer dominance.

Identify the roles users play in social media content creation and sharing.

Understand the concept of vertical and focused networks based on common interests.

Comprehend identity management across social networking sites, including issues of portability and security.

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Definitions:

Parotid Swelling

An enlargement or inflammation of the parotid glands, typically indicative of an infection, blockage, or autoimmune disorder.

Constipation

A common condition characterized by difficulty in passing stool or infrequent bowel movements.

Hypotension

A condition where blood pressure is lower than the normal range, potentially leading to symptoms like dizziness or fainting.

Dental Caries

Tooth decay caused by bacterial infection, leading to cavities, pain, and tooth loss if untreated.