A patient presents with severe pain in the upper arm after a fall. The affected area is swollen, and the patient is unable to move the arm without significant pain. Imaging studies reveal a malignant bone tumor in the humerus with a transverse break through the lesion. What is osteosarcoma?

Choice A reason: Monitoring urine output is critical in sepsis-induced DIC, as it reflects renal perfusion and organ function. Decreased output may indicate hypoperfusion or acute kidney injury from microthrombi, common in DIC, making this a priority assessment to guide fluid and supportive therapy.

Choice B reason: White blood cell count is relevant in sepsis but less specific for DIC progression. It indicates infection severity but does not directly assess DIC’s coagulopathy or organ impact, making it a lower-priority assessment compared to organ function indicators.

Choice C reason: Level of consciousness is a priority, as DIC can cause cerebral microthrombi or hemorrhage, leading to neurological changes. Altered consciousness signals potential brain involvement or systemic hypoperfusion, necessitating immediate intervention, making this a critical assessment in sepsis with DIC.

Choice D reason: Weight assessment is not a priority in acute sepsis with DIC, as it does not directly reflect coagulopathy or organ dysfunction. Fluid shifts may occur, but urine output and other vital signs are more immediate indicators, making this non-essential.

Choice E reason: Oxygen saturation is crucial, as DIC can impair pulmonary perfusion through microthrombi, causing hypoxemia. Sepsis also increases oxygen demand, and low saturation indicates respiratory compromise, making this a priority assessment to ensure adequate oxygenation.

Choice A reason: Gout tophi are urate crystal deposits, typically on joints like the big toe, not widespread on hands. Osteoarthritis nodes (Heberden’s/Bouchard’s) are more common in elderly hands, so this is incorrect.

Choice B reason: Rheumatoid nodules occur in rheumatoid arthritis, usually near elbows, not diffusely on hands. Osteoarthritis nodes are bony growths on finger joints, more likely in this patient, so this is incorrect.

Choice C reason: Osteoarthritis nodes (Heberden’s and Bouchard’s) are bony lumps on finger joints, common in elderly women with joint pain. This matches the hand findings, making it the correct diagnosis.

Choice D reason: Carpal tunnel syndrome causes wrist pain and numbness, not joint lumps. Osteoarthritis nodes explain the hand bumps in this elderly patient, so this is incorrect.