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trauma

Practice targeted AMC-style multiple-choice questions on trauma.

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anticoagulationchest painemergency medicinegeriatricsshortness of breathwarfarinelderly patienthypotensioninsomnianightmares
CT scan showing hemothorax caused by warfarin use
Image by Cevik Y — CC BY 3.0 · Source

A 68-year-old male on warfarin presents post-fall with dyspnea and pleuritic chest pain. INR is 4.8. Vitals: HR 115, BP 95/60, RR 26, SpO2 89% on air. The provided image was obtained. What is the MOST appropriate next step?

A. Perform needle thoracostomy
B. Order a V/Q scan
C. Administer vitamin K
D. Insert a chest tube
E. Administer IV fluids and observe
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A 28-year-old male is brought to the emergency department after a high-speed motor vehicle accident. He is unconscious with a Glasgow Coma Scale (GCS) score of 6. His blood pressure is 90/60 mmHg, heart rate is 120 bpm, and respiratory rate is 28 breaths per minute. On examination, there is bruising over the left chest and decreased breath sounds on the left side. What is the most appropriate immediate management step?

A. Order a chest X-ray
B. Perform a FAST (Focused Assessment with Sonography for Trauma) scan
C. Intubate and ventilate the patient
D. Perform needle decompression of the left chest
E. Administer intravenous fluids
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A lady stopped driving after being involved in an accident two years ago. She frequently experiences nightmares about the accident and has difficulty falling asleep. Her sister died a few months ago. What is the most likely diagnosis for her current symptoms?

A. Acute stress disorder
B. Grief reaction
C. Adjustment disorder
D. PTSD
E. Generalized Anxiety Disorder
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CT scan showing hemothorax caused by warfarin use
Image by Cevik Y — CC BY 3.0 · Source

A 72-year-old male on warfarin presents with sudden onset shortness of breath and right-sided chest pain after a fall. His INR is 4.5. The provided image was obtained. What is the MOST appropriate next step in management?

A. Administration of intravenous vitamin K
B. Bronchoscopy to rule out airway obstruction
C. Observation with serial chest X-rays
D. Administration of prothrombin complex concentrate
E. Insertion of an intercostal chest drain
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