Medical Council of Canada MCCQE Part 1 Exam MCCQE Question # 61 Topic 7 Discussion
MCCQE Exam Topic 7 Question 61 Discussion:
Question #: 61
Topic #: 7
You are on duty in the Emergency Department when 5 patients are brought in by ambulance after a high-speed motor vehicle collision. Which one of the following patients requires the most urgent medical care?
A.
A 4-year-old girl with a visibly displaced ankle fracture, in great pain, with normal distal pulses and normal vital signs
B.
A 32-year-old man with a swollen and angulated thigh, a blood pressure of 112/96 mm Hg, and a pulse of 122/min
C.
A 23-year-old woman who lost consciousness for about 5 minutes and has a headache despite a normal neurological screening examination
D.
A 13-month-old child who is screaming constantly and for whom the triage nurse finds no obvious explanation
E.
A 72-year-old man with a history of myocardial infarction, with a blood pressure of 163/94 mm Hg, a heart rate of 92/min, and a capillary saturation of 95%
The patient with the angulated thigh, hypotension relative to baseline, and tachycardia likely has a femoral shaft fracture with concealed hemorrhage. This poses an immediate risk of hypovolemic shock and requires urgent assessment and stabilization.
Toronto Notes 2023 – Emergency Medicine, “Trauma Triage and Prioritization”:
“Patients with long bone fractures, especially femoral fractures, are at high risk for hemorrhage and should be prioritized for stabilization and hemorrhage control.”
MCCQE1 Objectives (Surgery > 51-1: Trauma):
“Candidates must prioritize trauma patients based on signs of instability or risk of deterioration, such as tachycardia and occult bleeding.”
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