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Fat embolism syndrome — USMLE Step 3 MCQ

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HardSurgery (post-operative, follow-up)Fat embolism syndromeUSMLE Step 3

A patient develops hypoxemia, confusion, petechiae, thrombocytopenia, and diffuse infiltrates 36 hours after intramedullary fixation of a femoral-shaft fracture. Which diagnosis is most likely?

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Correct answer: A — Fat embolism syndrome

The characteristic delayed triad after long-bone trauma is fat embolism syndrome. Management is supportive critical care; the alternatives lack the combined neurologic, cutaneous, respiratory, and hematologic pattern.

Reference: American College of Surgeons, Advanced Trauma Life Support: https://www.facs.org/quality-programs/trauma/education/advanced-trauma-life-support/