A 42-year-old man is trapped beneath his overturned tractor for hours. He is unconscious and shows no movement in his lower extremities. The most likely cause for this finding is:

Correct Answer: C

Rationale: The correct answer is C: Central cord syndrome. This syndrome is typically caused by hyperextension injuries in older individuals, resulting in motor weakness and sensory loss, often more pronounced in the upper extremities. In this case, the man's prolonged unconsciousness and lack of lower extremity movement fit the clinical presentation of central cord syndrome due to the mechanism of injury. The other choices are less likely as an epidural hematoma would present with focal neurological deficits, a pelvic fracture with lower extremity symptoms but not unconsciousness, and intracerebral hemorrhage with altered mental status and focal neurological deficits.

Correct Answer: B

Rationale: The correct answer is B: 400ml. In pediatric resuscitation, the initial fluid bolus is usually calculated based on weight. The standard recommendation is to give 20ml/kg of Ringers lactate solution in shock. In this case, the girl weighs 20kg, so 20 x 20 = 400ml. This volume helps to restore intravascular volume and improve perfusion. Choice A (200ml) is insufficient for her weight, C (440ml) is slightly excessive, and D (600ml) is too much and could lead to fluid overload and potential complications.

Correct Answer: A

Rationale: The correct answer is A, "Tracheobronchial injury." In this scenario, the persistent pneumothorax despite chest tube placement suggests air leakage from a larger airway, indicating tracheobronchial injury. Rib fractures (B) would not cause persistent pneumothorax. Pulmonary contusion (C) would present differently on imaging. Cardiac tamponade (D) involves blood accumulation in the pericardial sac, not air in the pleural space.

Correct Answer: D

Rationale: Rationale: D is correct because assessing respiratory status during pregnancy requires a comprehensive approach. Clinical examination, AP and odontoid views, or CT scans help evaluate the airway, breathing, and potential spinal injury. This is crucial to identify impending respiratory failure. Summary of Incorrect Choices: A is incorrect because respiratory assessment is part of the secondary survey, not the primary survey in trauma care. B is incorrect as respiratory assessments do not specifically exclude spinal injuries. C is incorrect as respiratory assessments are not indicated for all trauma patients, but for those with potential respiratory compromise.

Correct Answer: A

Rationale: The correct answer is A: Medicare. Medicare is specifically designed as a federal health insurance program for individuals who are 65 years of age or older, individuals with permanent kidney failure, and certain disabilities. It provides coverage for hospital care, medical services, and prescription drugs for eligible individuals. Choice B: Medicaid is a separate federal and state program that provides health coverage for low-income individuals and families. Choice C: Occupational Safety and Health Administration (OSHA) is a federal agency responsible for ensuring safe and healthy working conditions. Choice D: Health and Human Services (HHS) is a federal department that oversees various health and human services programs, but it is not a health insurance program specifically for the mentioned groups.