A 36-year-old male is taken to the emergency room after jumping from a building. Bilateral fractures to the femur were stabilized at the scene by emergency medical technicians. The patient is lucid upon questioning and his vitals are stable. Pain only at his hips was elicited. Cervical exam was not performed. What is the best imaging study for this patient?
AAP and lateral radiographs of hips
BLateral radiograph (x-ray) of hips
CMagnetic resonance imaging (MRI) of hips, knees, lumbar, and cervical area
DAnterior-posterior (AP) and lateral radiographs of hips, knees, lumbar, and cervical area
EComputed tomography (CT) scan of cervical spine, hips, and lumbar area
A 45-year-old woman, suspected of having colon cancer, is advised to undergo a contrast-CT scan of the abdomen. She has no comorbidities and no significant past medical history. There is also no history of drug allergy. However, she reports that she is allergic to certain kinds of seafood. After tests confirm normal renal function, she is taken to the CT scan room where radiocontrast dye is injected intravenously and a CT scan of her abdomen is conducted. While being transferred to her ward, she develops generalized itching and urticarial rashes, with facial angioedema. She becomes dyspneic. Her pulse is 110/min, the blood pressure is 80/50 mm Hg, and the respirations are 30/min. Her upper and lower extremities are pink and warm. What is the most appropriate management of this patient?
AAdminister broad-spectrum IV antibiotics
BAdminister vasopressors (norepinephrine and dopamine)
CAdminister IM epinephrine 1:1,000, followed by steroids and antihistamines
DPerform IV resuscitation with colloids
EObtain an arterial blood gas analysis
A 37-year-old woman presents to the Emergency Department after 8 hours of left sided flank pain that radiates to her groin and pelvic pain while urinating. Her medical history is relevant for multiple episodes of urinary tract infections, some requiring hospitalization, and intravenous antibiotics. In the hospital, her blood pressure is 125/83 mm Hg, pulse of 88/min, a respiratory rate of 28/min, and a body temperature of 36.5°C (97.7°F). On physical examination, she has left costovertebral tenderness and lower abdominal pain. Laboratory studies include a negative pregnancy test, mild azotemia, and a urinary dipstick that is positive for blood. Which of the following initial tests would be most useful in the diagnosis of this case?
AUrine osmolality
BFractional excretion of sodium (FeNa+)
CRenal ultrasonography
DContrast abdominal computed tomography
EBlood urea nitrogen (BUN): serum creatinine (SCr) ratio
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