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Splenic rupture — MCCQE Part 1 MCQ

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ModerateTraumaSplenic ruptureMCCQE Part 1

A 24-year-old hockey player is hit in the left upper abdomen and later develops shoulder-tip pain, hypotension and abdominal tenderness. Which of the following is the most appropriate next step?

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Correct answer: B — Activate trauma surgery assessment and resuscitation for suspected intra-abdominal bleeding

Activate trauma surgery assessment and resuscitation for suspected intra-abdominal bleeding is the single best answer because the age, timing, examination findings and investigations in the vignette fit Splenic rupture better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to ATLS Canada guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: ATLS Canada guidance