A 67-year-old woman has fallen from the second story level of her home while hanging laundry. She was brought to the emergency department immediately and presented with severe abdominal pain. The patient is anxious, and her hands and feet feel very cold to the touch. There is no evidence of bone fractures, superficial skin wounds, or a foreign body penetration. Her blood pressure is 102/67 mm Hg, respirations are 19/min, pulse is 87/min, and temperature is 36.7°C (98.0°F). Her abdominal exam reveals rigidity and severe tenderness. A Foley catheter and nasogastric tube are inserted. The central venous pressure (CVP) is 5 cm H2O. The medical history is significant for hypertension. Which of the following is best indicated for the evaluation of this patient?
AX-Ray
BUltrasound
CPeritoneal lavage
DCT scan
EDiagnostic laparotomy
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 15-year-old boy is brought to the emergency department one hour after sustaining an injury during football practice. He collided head-on into another player while wearing a mouthguard and helmet. Immediately after the collision he was confused but able to use appropriate words. He opened his eyes spontaneously and followed commands. There was no loss of consciousness. He also had a headache with dizziness and nausea. He is no longer confused upon arrival. He feels well. Vital signs are within normal limits. He is fully alert and oriented. His speech is organized and he is able to perform tasks demonstrating full attention, memory, and balance. Neurological examination shows no abnormalities. There is mild tenderness to palpation over the crown of his head but no signs of skin break or fracture. Which of the following is the most appropriate next step?
ADischarge without activity restrictions
BDischarge and refrain from all physical activity for one week
CObserve for 6 hours in the ED and refrain from contact sports for one week
DAdminister prophylactic levetiracetam and observe for 24 hours
EAdminister prophylactic phenytoin and observe for 24 hours
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