Welcome. My name is Devine. This is episode 533 of the Devine

Intervention Podcasts. In today's podcast, we're going to be continuing the series

on the 2024, USMLE Step 2 CK Free 120.

We've done the first 80 question, so we're going to start with Block 3.

My go to this to hopefully go from questions 81 to 90.

Let's get right into it.

So question 81, a 28 year old man

is admitted to the intensive care unit three hours after undergoing

a resection and an astomosis of a small bowel injury and an afflictomy because of a

right renal laceration sustained in a motor vehicle collision. He also has bilateral,

millirmally displaced pubic rhemy fractures. He is intubated and mechanically ventilated.

He is receiving morphine and propophore.

He responds only to painful stimuli. Pulse is 110 per minute.

Ventilatory rate is 12 per minute and blood pressure is 133 over 68 millimeters of mercury.

The abdomen is distended and soft and the incision is clean, dry and intact.

Since the operation, urine output has been 40 millililiter per hour and bloody.

During the past hour, urine output has been 5 milliliter and bloody. In addition to intravenous

administration of 0.9% saline, which are the following is the most appropriate

next step in management. Option A, CT scan of the abdomen and pelvis, option B, repeat surgical exploration of the

abdomen, option C, transmission of packed red blood cells, option D, ultrasonography of the bladder.

Again, before we start dealing with the answers, what's going on here?

So this person basically was in trauma and the person injured their kidney and their small bowel and the

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