No Obvious External Bleeding in Surgery — Case | Trauma Surgery | SMLE Q#12093

SMLE Question #12093

Surgery Trauma Surgery

Objective: OBJ-TRM-AIRWAY-01

Last updated: February 2026
Previously healthy 30-year-old man is brought to the emergency department 4 hours after being hit by a truck. He is increasingly dyspneic and lightheaded, anxious, and diaphoretic. Exam shows markedly distended jugular veins at 45°, muffled heart sounds, cool clammy extremities, and clear lungs bilaterally with no obvious external bleeding. What type of shock is most likely?

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