tommyk
10-03-2006, 12:10 PM
Hy 2407 What is it Pathology?
25-year-old man named Vin Diesel is stabbed once in the right chest. The entrance wound is on the midaxillary line, at the level of the fifth intercostal space. He arrives at the emergency department w/ S.O.B., asking you to make sure he is good to go to make his next film. He seems hurt but not in shock and has no distended veins visible in his neck or forehead. His blood pressure is 140/80 mm Hg, and his pulse is 90/min. Physical examination of the chest shows the wound, which is not visibly sucking air, and demonstrates no breath sounds at all on the right side, (Big Hint). There is no evidence of mediastinal displacement. (Another BIG hint). What is this pathology? What will you do?
1-Cardiac Tamponade
2-Neurogenic shock
3-Pneumothorax
4-Hemothorax
Again, What will you do?
a) The clinical picture is that of a pneumothorax, NON-life threatening because he is TALKING to you which means his airway is fine (thus no intubation needed). Also, do not put a chest tube in this non-life threatening condition. If it were me, I would order a chest x-ray and clean and dress the wound. Remember that the Boards wants you to be able to assess the pathology based on the apparent SERIOUSNESS.
25-year-old man named Vin Diesel is stabbed once in the right chest. The entrance wound is on the midaxillary line, at the level of the fifth intercostal space. He arrives at the emergency department w/ S.O.B., asking you to make sure he is good to go to make his next film. He seems hurt but not in shock and has no distended veins visible in his neck or forehead. His blood pressure is 140/80 mm Hg, and his pulse is 90/min. Physical examination of the chest shows the wound, which is not visibly sucking air, and demonstrates no breath sounds at all on the right side, (Big Hint). There is no evidence of mediastinal displacement. (Another BIG hint). What is this pathology? What will you do?
1-Cardiac Tamponade
2-Neurogenic shock
3-Pneumothorax
4-Hemothorax
Again, What will you do?
a) The clinical picture is that of a pneumothorax, NON-life threatening because he is TALKING to you which means his airway is fine (thus no intubation needed). Also, do not put a chest tube in this non-life threatening condition. If it were me, I would order a chest x-ray and clean and dress the wound. Remember that the Boards wants you to be able to assess the pathology based on the apparent SERIOUSNESS.