The Daily PANCE and PANRE Question 46

A 17-year-old male is stabbed in the anterior chest with an ice pick. He quickly becomes hypotensive, tachycardic and obtunded. His breath sounds are equal, his neck veins are distended, and his chest x-ray is normal. What condition is most likely? Simple pneumothorax Tension pneumothorax Pericardial Tamponade aortic laceration distal to the origin of the left common carotid artery inferior vena cava laceration Answer:C Pericardial Tamponade This is the typical clinical presentation of tamponade (hypotension, JVD). He was stabbed and probably has a mediastinal bleed (so, I think the mediastinum would be widened on his chest film but the "normal CXR" is what rules out the pneumothorax - another common problem in a stabbing injury. Know Your NCCPAContent Blueprint Pericardial Tamponade is covered in theNCCPA ContentBlueprint Cardiology System (16%) Learn more about pericardial tamponadeand take the cardiology comprehensive examat SMARTY PANCE Cardiac Tamponade Note: * This is part of the Daily PANCE and PANRE in your inbox email series: 60 days of PANCE and PANRE Questions and Answers delivered directly to your inbox. It is a great and fun way to learn! If you haven't already, you can sign up for FREE by clicking Here. Help support The PA Life for FREE! This is provided as an opportunity for anyone who appreciates this email series to help support it painlessly. If you are going to be purchasing anything from Amazon.com (books, school supplies, etc.) simply start your next Amazon.com purchase by clicking here... it's a free way for you to help support the cause! Just click over to Amazon.com then, when you make your purchase, Amazon will send a portion of the proceeds to The Physician Assistant Life. 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