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North American pit viper envenomation — ABEM Board MCQ

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ModerateEnvironmental emergenciesNorth American pit viper envenomationABEM Board

A 52-year-old landscaper presents as triage level 2 after a rattlesnake bite to the hand. Swelling is progressing past the wrist, platelets are 82,000/microL, fibrinogen is low, and pain is severe. Which of the following is the most appropriate imaging study?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — No routine imaging is needed before antivenom decision-making

Progressive swelling and coagulopathy after pit viper bite indicate antivenom; imaging should not delay treatment unless a specific complication is suspected.

Reference: Wilderness Medical Society pit viper guideline; ABEM EM Model