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NBME 20 Answers

nbme20/Block 2/Question#20

A 19-year-old man who is a college student is ...

Subcutaneous crepitus

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submitted by strugglebus(75),

Bronchophony= pneumonia Expiratory stridor= tracheobronchial obstruction (mass/foreign body) Inspiratory stridor = laryngeal obstruction Succussion splash= test for pyloric stenosis

When there is a fractured rib it will cause a trauma pnemothorax which can cause air to escape and become trapped under the skin leading to crepitus.

charcot_bouchard  Actually when a fractured rib puncture lung then it cause sc emphysema. +  




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submitted by monoloco(64),

I have regarded crepitus as the rubbing of bone-on-bone. My study partner and I think this is a purely definitional question. Yes, crepitus could also be trapped air. Context, I guess.

medstudent65  Crepitus is used to describe bone-on-bone grinding. Subcutaneous crepitus is very specific sound referencing air finding its way into the skin which you can hear but also feel by rubbing your hand over the affected area. The addition of subcutaneous lets you know we are specifically talking about air in the skin. +1  






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submitted by rio19111(5),

Diagnosis: Pneumomediastinum (FA 2019, 659)

+Hamman Sign=Crepitus on cardiac auscultation

Etiology: spontaneous (due to rupture of pulmonary bleb) or 2° (eg, trauma, iatrogenic, Boerhaave syndrome).

md_caffeiner  also look on FA 667 traumatic pnx where it says "rib fracture" +