151.A 45-year-old man is brought into the ED after a head-on motor
vehicle collision. His BP is 85/45 mm Hg and HR is 130 beats per minute.
He is speaking coherently. His breath sounds are equal bilaterally. After 2 L
of fluid resuscitation, his BP is 80/40 mm Hg. A FAST examination reveals
fluid in Morison pouch. Which of the following organs is most likely to be
injured in blunt abdominal trauma?
a. Liver
b. Spleen
c. Kidney
d. Small bowel
e. Bladder
152.A 47-year-old man is brought into the ED after falling 20 ft from a ladder.
His HR is 110 beats per minute, BP is 110/80 mm Hg, RR is 20 breaths per
minute, and oxygen saturation is 100% on face mask. He is able to answer your
questions without difficulty. His chest is clear with bilateral breath sounds,
abdomen is nontender, pelvis is stable, and the FAST examination is negative.
You note a large scrotal hematoma and blood at the urethral meatus. Which of
the following is the most appropriate next step in management?
a. Scrotal ultrasound
b. Kidney-ureter-bladder (KUB) radiograph
c. IV pyelogram
d. Retrograde cystogram
e. Retrograde urethrogram
153.A 17-year-old man presents to the ED after getting hit in the right eye
with a tennis ball during a tennis match. On arrival to the ED, you note
periorbital swelling and ecchymosis. The patient’s visual acuity is 20/20.
When you are testing his extraocular muscles, you note that his right eye
cannot look superiorly but his left eye can. He also describes pain in his
right eye when attempting to look upward. Which of the following is the
most likely diagnosis?
a. Zygomatic arch fracture
b. Orbital floor fracture
c. Retrobulbar hematoma
d. Ruptured globe
e. Mandible fracture with entrapment of the pterygoid
Trauma 141