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Postoperative neck hematoma — USMLE Step 3 MCQ

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HardSurgery (post-operative, follow-up)Postoperative neck hematomaUSMLE Step 3

A 57-year-old woman has dyspnea and stridor 6 hours after anterior cervical spine surgery. The neck dressing is tense and swelling is visible under the incision. Oxygen saturation is 88% despite supplemental oxygen, and she is anxious. Which of the following is the most likely diagnosis?

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Correct answer: A — Postoperative neck hematoma causing airway compromise

Rapid neck swelling with stridor after anterior neck surgery suggests expanding hematoma with airway compromise. This is a surgical emergency requiring immediate airway management and wound decompression.

Reference: ACS postoperative airway emergency guidance