Monday, March 19, 2018

Fat Embolism Syndrome (FES) triad

Q: The classic triad of Fat Embolism Syndrome (FES) is?

A) Hypoxemia, neurologic abnormalities, and  thrombocytopenia
B) Hypoxemia, neurologic abnormalities, and a  petechial rash
C) Hypoxemia, lipiduria, and a petechial rash
D) Hypoxemia, fat globules in the pulmonary circulation, and a petechial rash
E) Hypoxemia, fat globules in the pulmonary circulation, and coagulation abnormalities

Answer: B

The objective of above question is to emphasize that FES is a clinical diagnosis. Radiological and laboratory workup is supportive. Only choice B has three clinical findings. All other choices include diagnostic workup. Classic triad is
  •  hypoxemia, 
  • neurologic abnormalities, and 
  • a petechial rash
Thrombocytopenia, lipiduria, coagulation abnormalities, presence of fat in the sputum, and fat analysis from a wedged sample from a pulmonary artery catheter are all supportive. Also, treatment is supportive till condition resolves by itself.


Georgopoulos D, Bouros D. Fat embolism syndrome: clinical examination is still the preferable diagnostic method. Chest 2003; 123:982.

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