Injuries and wounds: cardiac tamponade: practice question

A Forensic Medicine 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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Forensic Medicine · Injuries and wounds: cardiac tamponade

Sample item

A man with a stab wound to the left parasternal chest arrives with blood pressure 70/40, distended neck veins and muffled heart sounds. What is the best immediate step?

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

The answer and the reasoning

C. Emergency pericardial decompression

Hypotension, raised venous pressure and muffled sounds form Beck's triad of tamponade. The blood in the pericardium must be released by pericardiocentesis or surgical decompression, since fluids only temporise. Scanning wastes time in an unstable patient.

Option by option

  • A. Insertion of an intercostal drain

    A chest drain treats blood or air in the pleura and does not relieve tamponade.

  • B. CT of the chest before intervention

    Imaging delays treatment in an unstable patient.

  • C. Emergency pericardial decompression (correct)

    Correct. Relieving the pericardial blood is lifesaving in tamponade.

  • D. A large fluid bolus alone

    Fluids may support pressure briefly but do not remove 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.

More Forensic Medicine questions

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is C, Emergency pericardial decompression. Hypotension, raised venous pressure and muffled sounds form Beck's triad of tamponade.

Why is "Insertion of an intercostal drain" not the answer?

A chest drain treats blood or air in the pleura and does not relieve tamponade.

Why is "CT of the chest before intervention" not the answer?

Imaging delays treatment in an unstable patient.

Why is "A large fluid bolus alone" not the answer?

Fluids may support pressure briefly but do not remove the cause.

What concept does this question test?

It tests Injuries and wounds: cardiac tamponade in Forensic Medicine. The blood in the pericardium must be released by pericardiocentesis or surgical decompression, since fluids only temporise. Scanning wastes time in an unstable patient.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Injuries and wounds: cardiac tamponade?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine 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.