Consumptive coagulopathy from massive transfusion Quiz: Ace Your Exams
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A 26-year-old man presents to the trauma bay of the emergency department (ED) after involvement in a motor vehicle collision. He was the unrestrained driver in a head-on collision with a truck traveling approximately 50 miles per hour. Upon arrival at the ED, the patient is intubated for airway protection, and shortly thereafter he becomes pulseless. Three rounds of CPR are administered with a return of spontaneous circulation. Massive transfusion protocol (MTP) is initiated. The patient is subsequently taken to the operating room and undergoes an uncomplicated splenectomy and liver laceration repair. He is admitted to the ICU for further management. 12 hours after his presentation to the ED, there is blood oozing from multiple lines and wounds. Lab work reveals prolonged aPTT and PT decreased fibrinogen level, and elevated d-dimer. Which of the following physical exam findings would be expected based on this patient’s likely underlying diagnosis?
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