A construction worker was accidentally shot with a nail gun. The nail penetrated the skull approximately ½ inch through the temporal region. Before your arrival, coworkers pulled the nail free. Based on the mechanism of injury, which sign provides the strongest evidence that the meningeal layers have been breached?

A) Blood draining from the puncture wound
B) Crepitus of the skull at the injury site
C) Deformity and depression at the injury site
D) Cerebrospinal fluid oozing from the puncture wound
emergency-medical-services

What condition is most likely present when a normal p wave is negatively deflected?

If you feel pain while stretching, you should do any of the following except: a. stretch farther. b. back off the stretch. c. find an alternative. d. stop stretching.

A35-year-old woman comes to the ed complaining of chest pressure. she has had such episodes intermittently over the last 5 years, usually when sleeping, but over the last year she has had more frequent severe symptoms that are occasionally associated with severe migraine headaches. the pain is midsternal and is described as pressure that extends as a band around her chest. the ed physician is initially dubious that the pain is cardiac in origin, because the woman has no coronary disease risk factors. an ecg, however, shows 2mm st-segment elevation and inverted t waves in leads v1 through v5 and 1mm st-segment depression in leads ii, iii, and avf. before the cardiologist arrives in the ed, the patient's ecg has returned to normal. this repeat normal ecg is obtained after the administration of aspirin, nitroglycerin, morphine, and oxygen. which of the following is most likely for these findings? - diffuse intimal thickening with focal areas of atherosclerotic narrowing - intermittent thrombus formation and lysis in the left anterior descending artery - intermittent thrombus formation and lysis in the right coronary artery - plaque rupture and thrombus formation in the left anterior descending artery - transiently increased coronary vascular tone in the right coronary artery