This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: NEET 2019, Subject name: Surgery
[{'content': 'A 40 years old male was brought emergency with severe abdominal pain. On examination, pulse rate was 112/minute and systolic BP was 80 mmHg. Chest x-ray is given below. What is the most appropriate management? \nSelect and explain. \nA. Exploratory laparotomy, B. Saline wash of stomach, C. Intercostal tube drainage, D. IV antibiotics', 'role': 'user'}, {'content': 'Answer: A \nExplanation: From the given hx.: Pulse rate - 112 / min - Tachycardia - Indicates that patient is in Shock SBP - 80 mmHg - Low Bp X-ray shows: - Free gas under the right dome of diaphragm - Pneumoperitoneum - Due to perforation peritonitis which may be due to GI perforation such as perforated gastric ulcer, appendix or diveiculum Investigation: 1st investigation: X-ray Best IOC: Spiral CT T/t of choice: exploratory laparotomy', 'role': 'assistant'}]