Abdominal Trauma Flashcards
Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE?
a. The fetus is in jeopardy only with major abdominal trauma.
b. Leakage of amniotic fluid is an indication for hospital admission.
c. Indications for peritoneal lavage are different from those in the nonpregnant patient.
d. Penetration of an abdominal hollow viscus is more common in late than in early pregnancy.
b. Leakage of amniotic fluid is an indication for hospital admission.
A 26-year-old seat-belted driver is brought to the hospital after a car crash. Primary survey reveals no evidence of serious injury except for diffuse, mild abdominal tenderness. Bowel sounds are hypoactive and liver dullness is questionable. Abdominal films reveal free air. The patient should
a. undergo peritoneal lavage.
b. undergo prompt laparotomy.
c. be carefully observed for further evidence of intra-abdominal injury.
d. have a contrast roentgenographic study of the gastrointestinal tract.
e. be suspected of having a ruptured diaphragm and accompanying pneumothorax.
b. undergo prompt laparotomy.
Which of the following injuries is most likely to be missed by FAST or DPL?
a. Mesenteric laceration
b. Splenic capsular laceration
c. Ileal rupture
d. Hepatic fractures
e. Duodenal rupture
e. Duodenal rupture
A 25-year-old man is brought to a hospital with a general surgeon after being involved in a motor vehicle crash. Computed tomography shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT. The next step is:
a. contrast angiography
b. transfer to a higher level trauma center
c. exploratory laparotomy
d. infuse additional crystalloids
c. exploratory laparotomy
The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by:
a. reducing the need for blood transfusion
b. increasing the risk of pulmonary edema
c. reducing the volume of crystalloid required for resuscitation
d. increasing the volume of blood loss to produce maternal hypotension
d. increasing the volume of blood loss to produce maternal hypotension
A hemodynamically normal 10-year-old girl is admitted to the Pediatric Intensive Care Unit (PICU) for observation after a Grade III (moderately severe) splenic injury has been confirmed by computed tomography (CT). Which of the following mandates prompt celiotomy (laparotomy)?
a. a serum amylase of 200
b. a leukocyte count of 14,000
c. extraperitoneal bladder rupture
d. free intraperitoneal air demonstrated on follow-up CT
d. free intraperitoneal air demonstrated on follow-up CT
A healthy young male in a motor vehicle crash is brought to the emergency department with a blood pressure of 84/60, pulse 123, GCS 10. The patient moans when his pelvis is palpated. After initiating fluid resuscitation, the next step in management is:
a. placement of a pelvic binder
b. transfer to a trauma center
c. pelvic x-ray
d. repeat examination of pelvis
a. placement of a pelvic binder
Which of the following statement typically characterizes the syndrome of overwhelming postsplenectomy sepsis?
a. a syndrome of gram negative bacterimia and septicemia
b. a syndrome caused by impaired host ability to mount an effective humoral response to infection
c. a syndrome of rapidly appearing septic shock unresponsive to antibiotic therapy, with an average mortality of 50%
d. a syndrome that maybe prevented by preserving as little as 15% of splenic mass in adult trauma victims
b. a syndrome caused by impaired host ability to mount an effective humoral response to infection
Which is incorrect of abdominal trauma?
a. Spleen is most commonly injured viscus in blunt trauma.
b. Liver is most commonly injured viscus in penetrating trauma.
c. Conservative management of ruptured spleens is more successful in children.
d. Delayed splenic rupture is seen in splenic injuries due to liquefaction of haematoma.
b. Liver is most commonly injured viscus in penetrating trauma.
Which is incorrect of abdominal trauma?
a. Abdominal exam is not included in the primary survey.
b. Presence of free gas on plain radiography indicates need for immediate laparotomy.
c. Warmed ringers or saline of 10ml/kg should be instilled for DPL.
d. Free aspiration of 20ml of blood in adults and 10 ml in children is a positive DPL
c. Warmed ringers or saline of 10ml/kg should be instilled for DPL.
