Day 4 - Trauma Quiz

Question 1

Radiographic study used to study injury to the urethra

Answer 1

Retrograde cystourethrogram

Question 2

Sx basilar skull fracture

Answer 2

Racoon’s eyes (orbital fracture), Battle sign (bruising of mastoid process), Blood behind TM, CSF out of nose/ears

Question 3

Chest trauma, hypotension, JVD, muffled heart sounds - Dx & Mgt

Answer 3

Cardiac tamponade - Pericardiocentesis

Question 4

Chest trauma, hypotension, JVD, respiratory distress - Dx & Next step

Answer 4

Tension pneumothorax - Needle decompression & chest tube placement

Question 5

Next step for penetrating injury in different zones of the neck

Answer 5

Zone 1: CT angiogram (4-vessel angiogram); Zone 2: surgical expxloration; Zone 3: CT angiogram & triple endoscopy

Question 6

Interventions effective in mgt of elevated ICP

Answer 6

Raise head of bed at 30 degrees; If intubate, give lidocaine first; Mannitol (IV q 6 hr); Intubating & hyperventilating pt; Definitive - Decompressing craniectomy

Question 7

Criteria met prior to d/c of pregnant women being observed for traumatic event

Answer 7

Contractions limited to no more than 1 every 10 min; No vaginal bleeding or abdominal pain; Normal fetal heart tracing

Question 8

Next step - Pelvic fracture, DPL shows blood in pelvis

Answer 8

Emergency laparotomy

Question 9

Next step - Pelvic fracture, DPL shows urine in the pelvis

Answer 9

Urgent laparotomy

Question 10

Next step - Pelvic fracture, DPL shows nothing, still hemodynamic instability

Answer 10

Assume retroperitoneal hematoma; Angiography w/ possible embolization

Question 11

Blunt abdominal trauma, unstable VS, FAST shows fluid in pelvis

Answer 11

Emergency laparotomy (suspect fluid = blood)

Question 12

Blunt abdominal trauma, unstable VS, FAST shows no fluid in pelvis

Answer 12

Assume retroperitoneal hematoma; Angiography w/ possible embolization

Question 13

Blunt abdominal trauma, unstable VS, FAST inconclusive

Answer 13

Different study - DPL

Question 14

Blunt abdominal trauma, stable VS

Answer 14

CT abdomen/pelvis

Question 15

Abdominal stab wound, hypotensive, signs of peritonitis

Answer 15

Emergency laparotomy or celiotomy

Question 16

Additional studies can be done in stable pt w/ abdominal stab wound that penetrated peritoneum

Answer 16

DPL, upright CXR, diagnostic US, Abdominal CT w/ contrast, or straight to diagnostic laparoscopy