This patient presented is admitted to your ICU with respiratory failure following a motor vehicle accident. The following clinical sign (see picture below) were present on examination of the patient.
(image link is from www.springerimages.com)
a) What clinical sign is illustrated in this picture?
b) What is the likely cause of the respiratory failure?
College Answer
a) What clinical sign is illustrated in this picture?
Conjunctival petechiae
b) What is the likely cause of the respiratory failure?
Fat embolism syndrome
Discussion
This question depicts a well known clinical sign and does not require a massive amount of cognitive effort.
Fat embolism syndrome has well-described features, and most people will connect trauma, breathing difficulty and conjunctival petechii. Fat rises, and the petechii appear on whatever the uppermost bodypart happens to be.
References
Gurd, Alan R., and R. I. Wilson. "The fat embolism syndrome." Journal of Bone & Joint Surgery, British Volume 56.3 (1974): 408-416.
Tachakra, S. S. "Distribution of skin petechiae in fat embolism rash." The Lancet 307.7954 (1976): 284-285.