Trauma: flail chest: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Trauma: flail chest

Sample item

A patient has paradoxical movement of a segment of the right chest wall after multiple rib fractures and is hypoxic. What is the main cause of hypoxia?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Underlying pulmonary contusion

Flail chest is caused by two or more fractures in two or more ribs, and hypoxia arises chiefly from the underlying pulmonary contusion and pain-related hypoventilation, not the paradoxical motion alone. Treatment is oxygen, analgesia including regional blocks, and ventilatory support when needed. Fluids are given cautiously to avoid worsening the contusion.

Option by option

  • A. Diaphragmatic paralysis

    The diaphragm is not paralysed.

  • B. The paradoxical movement itself

    Paradoxical motion contributes less than the contused lung.

  • C. Underlying pulmonary contusion (correct)

    Correct. Pulmonary contusion drives the gas exchange problem.

  • D. Pericardial effusion

    Pericardial effusion is not the cause.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Underlying pulmonary contusion. Flail chest is caused by two or more fractures in two or more ribs, and hypoxia arises chiefly from the underlying pulmonary contusion and pain-related hypoventilation, not the paradoxical motion alone.

Why is "Diaphragmatic paralysis" not the answer?

The diaphragm is not paralysed.

Why is "The paradoxical movement itself" not the answer?

Paradoxical motion contributes less than the contused lung.

Why is "Pericardial effusion" not the answer?

Pericardial effusion is not the cause.

What concept does this question test?

It tests Trauma: flail chest in General Surgery. Treatment is oxygen, analgesia including regional blocks, and ventilatory support when needed. Fluids are given cautiously to avoid worsening the contusion.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma: flail chest?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.