Following blunt injury to the anterior torso, a patient is coughing up bright red blood. You should be MOST suspicious of:

• A. Gastrointestinal bleeding
• B. Severe myocardial damage
• C. Bleeding within the lungs
• D. Intraabdominal bleeding

Answer: (C)

Hemoptysis after blunt chest trauma points to injury inside the lungs or airways. Bright red sputum indicates arterial or bronchial bleeding within the pulmonary system, which is typical of pulmonary contusion or laceration. In contrast, a gastrointestinal bleed would usually present with vomiting blood or black/tarry stools, not coughing up blood. An intraabdominal bleed presents with abdominal signs and symptoms rather than blood in the airway. Severe myocardial damage would cause chest pain and other cardiac symptoms, not hemoptysis. So the finding is most suspicious for bleeding within the lungs, such as pulmonary contusion or airway/lung injury.