A 34-year-old woman is admitted to the hospital after sustaining a displaced right femoral fracture in a motor vehicle accident. She undergoes open reduction and internal fixation with intramedullary nailing. On postoperative day 2, she develops acute dyspnea, tachycardia, and hypoxemia. Vital signs show: temperature 38.2°C (100.8°F), heart rate 118/min, respiratory rate 29/min, blood pressure 148/88 mm Hg, and O₂ saturation 84% on room air. Physical examination reveals scattered petechiae across the anterior chest wall and confusion (disoriented to time and place). Laboratory studies show hemoglobin 10.1 g/dL, platelets 135,000/mm³, and creatinine 1.3 mg/dL (baseline 0.9 mg/dL). Chest X-ray reveals scattered opacities bilaterally. Which of the following best explains the pathophysiology of this patient's acute presentation?

1. A)Thromboembolism from deep venous thrombosis in the fractured limb
2. B)Fat embolism syndrome from disruption of bone marrow during fracture and surgical fixationGABARITO
3. C)Acute respiratory distress syndrome secondary to systemic inflammatory response from trauma
4. D)Septic pulmonary embolism from hematogenous seeding of bacteria at the surgical site
5. E)Acute coronary syndrome with subsequent acute pulmonary edema