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Splenic rupture — USMLE Step 2 CK MCQ

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EasySurgerySplenic ruptureUSMLE Step 2 CK

A 41-year-old Native American woman comes to the hospital because of progressive symptoms. History and focused examination are notable for left upper quadrant pain, hypotension, and Kehr sign after blunt trauma. Temperature is 101.5°F (38.6°C), blood pressure is 82/48 mmHg, pulse is 132/min, respirations are 28/min, and oxygen saturation is 90% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and imaging support an acute surgical process without suggesting a safer outpatient approach. Which of the following is the most likely diagnosis?

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Correct answer: B — Splenic rupture

The vignette describes Splenic rupture, supported by left upper quadrant pain, hypotension, and Kehr sign after blunt trauma. Splenic rupture is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: Eastern Association for the Surgery of Trauma Splenic Injury Guideline