25- year-old student involved in a road traffic accident, was brought to the emergency department in shock. Examination showed low blood pressure and tenderness on the left mid- and posterior axillary line. X-ray revealed that his 10th ribs was fractured near their angle on the left

A previously healthy 24-year-old man is brought to the emergency department after a bicycle crash.  The patient was mountain biking downhill when he struck a prominent tree root and was thrown from his bike.  He tried to brace his fall with his hands, but his chest struck a large rock as he landed.  He did not hit his head or lose consciousness.  The patient has moderate central chest pain and severe right wrist pain.  Blood pressure is 142/86 mm Hg, pulse is 110/min, and respirations are 20/min.  Oxygen saturation is 98% on room air.  Physical examination is significant for sternal bruising with point tenderness, abrasions on both palms, and a deformed right wrist with an overlying laceration.  Breath sounds, heart sounds, and abdominal examination are normal.  Focused assessment with sonography for trauma is negative for free intraabdominal or pericardial fluid.  Noncontrast CT scan of the chest reveals a hairline sternal fracture.  Radiographs of the right wrist reveal a severely displaced, open fracture of the right distal radius.  The patient is hospitalized for operative irrigation, debridement, and fixation of the wrist fracture.  Throughout the day, the patient is noted to be persistently tachycardic even though he is afebrile and normotensive, with normal respirations and oxygen saturation.  Pain control is adequate.  ECG shows sinus tachycardia with frequent premature ventricular contractions.  Which of the following is the best next step in management of this patient?

While walking to class on an icy winter morning, a student slips and falls on her outstretched hand. The intense pain forces her to go to the emergency room. After X-rays of her wrist are taken, the attending says," You were lucky, there is no Colles' nor scaphoid fractures, but you have dislocated the middle carpal bone of the proximal row." Which bone was dislocated?

While performing CPR, you felt a rib was fractured. What should you do next?*1 pointStop CPRCheck hand position and continue compressionsPerform rescue breaths onlyCall a doctor

Your patient a 14 year old soccer player fell on the soulder and neck after scorring a goal, when she had her legs swept out from under her by a defensive player. she is unable to move her right arm and in shoulder flexion and abduction, muscles are graded at 2/5 on assessment.  The shoulder in internally rotated and her hand is in waiters tip position after a week.  The shoulder MRI was normal.  What is the clinical diagnosis

Your next patient is in a leg cast, and brings an x-ray with her that was taken at the hospital.Which diagnosis can be made from the x-ray?oblique fracture in the distal tibiaoblique fracture in the distal fibulatransverse fracture in the proximal tibiatransverse fracture in the proximal fibula