What is the most common cause of death in survivors of spinal cord injuries?
Cancer
Pneumonia
Suicide
Pulmonary embolus
The Correct Answer is B
Rationale:
A. Cancer can occur in individuals with spinal cord injuries, particularly due to long-term factors such as chronic inflammation, smoking, or reduced screening access. However, it is not the leading cause of death in this population. Although life expectancy has improved, cancer-related deaths are still less frequent compared to respiratory complications.
B. Pneumonia is the most common cause of death in survivors of spinal cord injuries. This is primarily due to impaired respiratory function. Injury to the spinal cord, especially at higher levels (such as cervical injuries), can weaken or paralyze the diaphragm and intercostal muscles, leading to shallow breathing and poor lung expansion. In addition, the cough reflex is often ineffective, preventing proper clearance of secretions. This leads to mucus accumulation, creating an environment for bacterial growth and infection. Immobility and prolonged bed rest further increase the risk of atelectasis and infection. Over time, repeated respiratory infections significantly increase mortality risk, making pneumonia the leading cause of death in this population.
C. Individuals with spinal cord injuries have a higher risk of depression, social isolation, and psychological distress, which can increase the risk of suicide. However, despite this elevated risk, suicide is not the most common cause of death when compared to medical complications such as respiratory infections.
D. Pulmonary embolism is a significant risk, particularly in the acute phase after injury due to immobility, venous stasis, and hypercoagulability. Preventive measures such as anticoagulation and compression devices have reduced its incidence. While it remains a serious complication, it is not the leading long-term cause of death compared to pneumonia.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Cardiac tamponade is a life-threatening condition caused by fluid accumulation in the pericardial sac, leading to impaired cardiac filling and decreased cardiac output. Although it can occur with chest trauma and cause rapid deterioration, it is not the most common cause of death in chest wall injuries. It is relatively less frequent compared to other thoracic injuries.
B. Hemothorax involves accumulation of blood in the pleural space, which can impair lung expansion and lead to hypovolemic shock. While it is a serious and potentially fatal complication, it is not the most common cause of death in chest wall trauma.
C. Pulmonary contusion is the most common cause of death associated with chest wall injury. It involves bruising of the lung tissue, leading to alveolar hemorrhage, edema, and impaired gas exchange. This results in hypoxia, respiratory failure, and can progress to acute respiratory distress syndrome (ARDS). The disruption of the alveolar-capillary membrane significantly compromises oxygenation, making it a leading cause of mortality in thoracic trauma.
D. Flail chest occurs when multiple adjacent ribs are fractured, causing a segment of the chest wall to move paradoxically during respiration. While it can impair ventilation and is often associated with pulmonary contusion, flail chest itself is not the most common direct cause of death. Mortality is usually related to the underlying pulmonary contusion rather than the mechanical instability alone.
Correct Answer is ["A","D"]
Explanation
Rationale:
A. The patient has a localized injury without signs of hemodynamic instability, internal bleeding, or organ compromise. While the injury is significant enough to require treatment, it is not immediately life-threatening, fitting the yellow tag (delayed care) category.
B. Ocular injuries, especially bilateral or penetrating injuries, are potentially vision-threatening and may require urgent surgical evaluation. Such patients are triaged red (immediate).
C. Neurologic deficits after trauma suggest spinal cord involvement, which is a high-priority, potentially life- or function-threatening injury. These patients are tagged red (immediate).
D. Burns that cover less than a critical total body surface area without airway involvement or signs of shock are serious but not immediately life-threatening, fitting yellow tag (delayed care). Patients can safely wait for definitive treatment while higher-priority cases are stabilized.
E. Altered level of consciousness is a critical sign of intracranial injury and possibly rising intracranial pressure. This requires immediate intervention, and the patient would be tagged red.
F. Absent distal pulses indicate vascular compromise, putting the patient at risk for limb loss or systemic complications. This is life- or limb-threatening and requires red (immediate) care.
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