A young male presented with dyspnea, bleeding and petechial hemorrhage in the chest after 2 days following fracture shaft of the femur right side. Most likely cause is:

Ans. (b) Fat embolism* Fat embolism usually manifests following Long bone fractures* MC after Closed fractures > Open fractures* MC in Young (more bone marrow) > Old* MC in Long bones (Femur) > Pelvis> Smaller bones* 90% will develop fat emboli after traumatic fracture but only 1-5% develop fat embolism syndrome* Also seen in other causes like- Pancreatitis, Fatty liver, Steroid therapy, Liposuction etc.* Fat embolism is a clinical diagnosis and not a Chemical diagnosis.* It manifests in 24-72 hours. Rare in < 24 hours and > 72 hours* Classic Triad- Hypoxemia + Petechial Rash + neurological abnormalities* Hypoxemia early finding, Petechial rash is late finding* Platelet count - Normal* Purtschers Retinopathy +* Lipiduria+* Treatment: Immobilization of fracture, Mechanical Ventilation, Steroids.