Fracture complications: practice question

A Orthopaedics 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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Orthopaedics · Fracture complications

Sample item

On day 2 after a closed femoral shaft fracture, a young man becomes breathless and confused, has low oxygen saturation and a petechial rash over the chest and axillae. What is the most likely diagnosis?

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

The answer and the reasoning

D. Fat embolism syndrome

Fat embolism syndrome follows long bone fractures, with respiratory distress, neurological changes and a petechial rash typically appearing one to three days after injury. The timing and rash distinguish it from thromboembolism. Management is supportive, with oxygenation and early fracture stabilisation.

Option by option

  • A. Anaphylaxis

    Anaphylaxis would present with urticaria, wheeze and hypotension shortly after an allergen exposure.

  • B. Hospital-acquired pneumonia

    Pneumonia does not explain the petechial rash and the early timing.

  • C. Deep vein thrombosis only

    Deep vein thrombosis alone does not cause petechiae or acute confusion.

  • D. Fat embolism syndrome (correct)

    Correct. Respiratory failure, confusion and petechiae after a long bone fracture define it.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Fat embolism syndrome. Fat embolism syndrome follows long bone fractures, with respiratory distress, neurological changes and a petechial rash typically appearing one to three days after injury.

Why is "Anaphylaxis" not the answer?

Anaphylaxis would present with urticaria, wheeze and hypotension shortly after an allergen exposure.

Why is "Hospital-acquired pneumonia" not the answer?

Pneumonia does not explain the petechial rash and the early timing.

Why is "Deep vein thrombosis only" not the answer?

Deep vein thrombosis alone does not cause petechiae or acute confusion.

What concept does this question test?

It tests Fracture complications in Orthopaedics. The timing and rash distinguish it from thromboembolism. Management is supportive, with oxygenation and early fracture stabilisation.

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 Fracture complications?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.