A 32-year-old hospitalized man is evaluated for new-onset shortness of breath and confusion. The patient was admitted for a displaced femoral neck fracture of the left hip acquired after a fall the day before. The surgery under general anesthesia with sevoflurane was uneventful. She appears cyanotic, drowsy, and is oriented only to person. Her temperature is 38.6°C (101.5°F), pulse is 135/minute, respirations are 36/min, and blood pressure is 155/95 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 81%. There are several scattered petechiae on the anterior chest wall. An ECG shows sinus tachycardia. Which of the following histologic changes has most likely taken place in this patient's lung tissue?

Question

A 32-year-old hospitalized man is evaluated for new-onset shortness of breath and confusion.  The patient was admitted for a displaced femoral neck fracture of the left hip acquired after a fall the day before. The surgery under general anesthesia with sevoflurane was uneventful. She appears cyanotic, drowsy, and is oriented only to person. Her temperature is 38.6°C (101.5°F), pulse is 135/minute, respirations are 36/min, and blood pressure is 155/95 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 81%. There are several scattered petechiae on the anterior chest wall. An ECG shows sinus tachycardia. Which of the following histologic changes has most likely taken place in this patient's lung tissue?

Quizplus · Accepted Answer

Eductional Objective: Fat embolism syndrome should be strongly suspected in a patient with severe long-bone and/or pelvic fractures who develops acute-onset neurologic abnormalities, hypoxemia, and a petechial rash.  Occlusion of the pulmonary microvessels by fat globules is an early histologic finding of this syndrome.

A 32-Year-Old Hospitalized Man Is Evaluated for New-Onset Shortness of Breath