Question 1

Question

A 35-year-old man suffers severe polytrauma including traumatic brain injury (GCS 6), pulmonary contusions, splenic laceration, and open femur fracture. He undergoes damage control surgery with splenectomy and external fixation. On ICU day 4, he develops worsening hypoxemia (PaO2/FiO2 ratio 150), bilateral infiltrates on chest X-ray, normal pulmonary capillary wedge pressure, petechiae, and altered mental status beyond his head injury. Fat globules are noted in urine. Platelet count drops from 245,000 to 89,000/μL. Evaluate the diagnosis and management priority.

Accepted Answer

Fat embolism syndrome; supportive care and definitive fracture fixation when stable

Answer

Sepsis from missed abdominal injury; return to OR for re-exploration

Answer

Transfusion-related acute lung injury; diuresis and transfusion avoidance

Answer

Disseminated intravascular coagulation; aggressive factor replacement

Answer

Acute respiratory distress syndrome; increase PEEP and lung-protective ventilation

Surgical complications — MCQs

Surgical complications — MCQs

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