Inservice deck 5 - major trauma and GU

Question 1

Number one cause of death in 1-19 year olds?

Answer 1

major trauma

Question 2

SAH patient intubated in ED, what medication should you give?

Answer 2

phenytoin/keppra for seizure prophylaxis

Question 3

Indications for thoracotomy in face of hemothorax?

Answer 3

blood loss > 1500 initially, blood loss > 200 ml/hr 2-4 hours, > 50% hemothorax

Question 4

unstable c spine fractures?

Answer 4

Jefferson bit off a hangman’s thumb

Jefferson fracture
bilateral facet
odontoid
atlanto-axial dissocation
hangman's
teardrop

Question 5

Feared complication of bilateral femur fracture and petechiae on chest?

Answer 5

fat emboli

Question 6

Which induction medication can cause chest and jaw rigidity? Tx?

Answer 6

fentanyl

narcan, paralyze, intubate and ventilate

Question 7

Most common abd organ injured in blunt trauma?

Answer 7

spleen

Question 8

Initial and next management steps for patient with penetrating sucking chest wound?

Answer 8

occlusion dressing, chest tube

Question 9

Patient who has thoracic trauma, what side should central line be placed?

Answer 9

same side as injury

Question 10

Next step in management of patient who has stab wound to the arm, audible thrill, and decreased pulses, once measures are initiated to control bleeding?

Answer 10

call vascular surgery

Question 11

patient with 50% pulmonary contusion of left lung is intubated but remains hypoxic. Next step/maneuver?

Answer 11

place right side good lung down.

Question 12

handlebar to gut = injury to what organ?

Answer 12

duodenum and/or pancreas

Question 13

Next action with concern for torsion and manual reduction fails?

Answer 13

call urology

Question 14

tx of prostatitis in > 35 year old without STD risk factors? < 35?

Answer 14

Bactrim or fluoroquinolone

ceftriaxone and doxy/azithro

Question 15

best indicator a kidney stone will pass on its own?

Answer 15

< 5 mm

Question 16

16 year old with testicular pain. Cremasterics intact. Elevation results in relief. Dx and tx? US shows?

Answer 16

epididymitis

cef and azithro

increased flow

Question 17

tx of patient with grey-white vaginal discharge, fishy odor with KOH and clue cells

Answer 17

BV

metronidazole 500 mg PO BID x 7 days

Question 18

next step in diagnosing female with RUQ pain, nl LFTs, with pain and tenderness throughout abdomen

Answer 18

pelvic exam

- perihepatitis gonorrhea infection

Question 19

65 year old male with renal colic and blood in urine. Next ED test?

Answer 19

abd US to rule out AAA

Question 20

sexual trauma that leads to priapism results in injury to what part of penis?

Answer 20

corporus cavernosum

Question 21

Which GU is true emergency phimosis or paraphimosis?

Answer 21

paraphimosis

Question 22

5 year old with abd pain, decreased UOP, HTN, febrile, petechiae, and RBCs and casts on UA

Answer 22

HUS

Question 23

5 year old with bilateral lower extremity swelling, large amt of protein on UA, periorbital edema?

Answer 23

nephrotic syndrome