Acute Care 5th Year

Question 1

AMPLE trauma history

Answer 1

Allergies
Medications
Past Medical History
Last ate
Events and Environment

Question 2

primary assessment identifies what

Answer 2

immediately life threatening injuries

Question 3

immediate priority in major trauma

Answer 3

Catastrophic external haemorrhage

Question 4

management of external haemorrhage

Answer 4

simple direct pressure
haemostatic dressings
torniquet

Question 5

what should all trauma patients recieve

Answer 5

high flow oxygen

Question 6

commonest cause of airway obstruction

Answer 6

tongue occluding the airway by falling onto posterior pharyngeal wall

Question 7

when should ahead tilt be avoided in trauma patients

Answer 7

potential C spine injury patients

Question 8

when should a nasopharyngeal airway be avoided

Answer 8

base of skull fracture

significant facial fractures

Question 9

if a trauma patient cannot be intubated or adequately ventilated what is the next management step

Answer 9

surgical airway with cricothyroidotomy

Question 10

what do paradoxical respiratory movements suggest in trauma patient

Answer 10

flail chest

Question 11

immediately life-threatening chest injuries detected in Primary Survey (ATOM FC)

Answer 11

airway obstruction
tension pneumothorax
open pneumothorax
massive haemothorax
flail chest
cardiac arrest

Question 12

patient who is tachycardic, hypotensive and in respiratory distress

Answer 12

tension pneumothorax

Question 13

landmark for needle thoracocentesis

Answer 13

second intercostal space, midclavicular line

Question 14

triangle of safety in intercostal drain insertion

Answer 14

posterior: latissimus dorsi
anterior: pectoralis major
inferior: 6th rib

Question 15

can children sustain lung trauma without fracturing ribs

Answer 15

yes

Question 16

shocked patient with respiratory compromise and dullness on percussion and reduced air entry

Answer 16

massive haemothorax

Question 17

management of open pneumothorax

Answer 17

cover wound with sterile occlusive dressing

chest drain insertion

Question 18

injuries associated with flail chest

Answer 18

pulmonary contusion (bruising of the lungs caused by chest trauma)

Question 19

management of flail chest

Answer 19

oxygen, analgesia

Question 20

n patients who present with a penetrating trauma to the chest, where there is high level of suspicion for cardiac tamponade, and who have had a witnessed cardiac arrest what should be performed

Answer 20

resuscitative throacotomy

Question 21

what type of shock do most trauma patients suffer

Answer 21

haemorrhagic

Question 22

causes of obstructive shock in the context of trauma

Answer 22

tension pneumothorax

cardiac tamponade

Question 23

type of shock presenting with hypotension and bradycardia

Answer 23

neurogenic

Question 24

during C assessment in primary survey what is vital to examine for

Answer 24

occult haemorrhage in abdomen and pelvis

Question 25

areas where haemorrhage must be considered in trauma

Answer 25

on the floor (external)
chest
abdomen 
pelvis
long bones

Question 26

most commonly injured organ in blunt abdominal trauma

Answer 26

spleen

Question 27

reasons why children are more prone to abdominal injuries

Answer 27

thin abdominal wall
diaphragm more horizontal so liver and spleen lie lower
elastic ribs offering less protection

Question 28

in penetrating trauma what is the most commonly injured organ

Answer 28

liver

Question 29

gold standard imaging modality in trauma

Answer 29

CT scan

Question 30

most common cause of pelvic # in elderly

Answer 30

fall from standing position

Question 31

if there are clinical concerns over pelvic trauma/fracture what should be applied

Answer 31

pelvic binder

Question 32

best option for definitive management of patients with ongoing haemorrhage

Answer 32

angiographic embolisation performed by interventional radiologist

Question 33

contents of “shock pack”

Answer 33

4 units of blood
4 units of FFP
a pool of platelets

Question 34

components of AVPU

Answer 34

Alert
responds only to Voice
responds only to Pain
Unresponsive

Question 35

components of GCS

Answer 35

Eyes 4
Movement 6
Voice 5

Question 36

what is Cushing’s response

Answer 36

triad of
bradycardia
hypertension
respiratory depression

Question 37

traumatic brain injury causing arterial bleed

Answer 37

extradural haematoma

Question 38

vessel involved in traumatic extradural haematoma

Answer 38

middle meningeal artery

Question 39

brain injury most common in older adults and alcoholics due to brain atrophy

Answer 39

subdural haematoma

Question 40

brain injury associated with contrecoup injuries

Answer 40

cerebral contusions

Question 41

drug used to lower ICP

Answer 41

mannitol

Question 42

in burns victims when should attempts at cooling be made

Answer 42

only if burn is <10% of total body surface

Question 43

indications of significant airway involvement in burns victims

Answer 43

loss of facial/nasal hair
intraoral burns/blisters
hoarse voice
carbonaceous speutum/soot in mouth
stridor/wheeze

Question 44

indications for intubation in patients with facial burns

Answer 44

persistent hypoxia despite high flow O2
actual or anticipated airway compromise
extensive burns

Question 45

in chest wall burns how are the tough inelastic tissues known as eschar, prevented

Answer 45

escharotomy where incisions are made through the eschar to expose underlying fatty tissue

Question 46

Parkland formula for burns

Answer 46

4 ml X weight (kg) x % burn

Question 47

how should resusitation fluids in burns victims be delivered

Answer 47

50% over first 8 hrs

remaining 50% over next 16 hrs