USMLE Step 2 Clinical Knowledge (CK) Practice Exam

In cases of fat embolism syndrome, respiratory distress arises due to fat globules entering the pulmonary circulation, leading to obstruction of small blood vessels in the lungs, inflammatory responses, and impaired gas exchange. The management of respiratory distress in this context focuses primarily on providing adequate respiratory support. This can include supplemental oxygen or mechanical ventilation, depending on the severity of the respiratory distress.

Respiratory support is crucial because it addresses the immediate need to improve oxygenation and ensure that the patient can breathe effectively. In some cases, it may be necessary to provide positive pressure ventilation to assist with the alveolar gas exchange that is compromised by the presence of fat globules in the lungs.

While other therapies such as bronchodilators or steroids might be considered in different clinical scenarios or for specific complications, they do not directly address the underlying issue of fat embolism-related respiratory distress. Antibiotics may be warranted if there is a secondary infectious process but are not a primary treatment for fat embolism itself. Therefore, the focus on providing respiratory support is the most appropriate and direct treatment for respiratory distress caused by fat embolism.