Major Trauma

Question 1

What is the leading cause of death in patients aged <44 y/o?

1 - cancer
2 - alcohol
3 - major trauma
4 - infection

Answer 1

3 - major trauma

• 15,000 deaths/y

Question 2

Is a tension pneumothorax dangerous?

Answer 2

• yes
• medical emergency
• respiratory distress and reduced venous return,

Question 3

What is typically the treatment of choice for isolated rib fractures?

1 - analgesics
2 - surgery
3 - casting
4 - bed rest

Answer 3

1 - analgesics

Question 4

Fracture of which rib generally requires the most trauma and is generally a sign of significant damage elsewhere?

1 - 12th rib
2 - 10th rib
3 - 4th rib
4 - 1st rib

Answer 4

4 - 1st rib

Question 5

What is the definition of shock?

1 - lack of respiratory drive
2 - failure of circulation to provide adequate perfusion of tissues
3 - increases tachycardia
4 - syncope

Answer 5

2 - failure of circulation to provide adequate

• various classes ranging from I - IV

Question 6

Which 2 of the following can cause preload shock?

1 - PVD
2 - increased intrathoracic pressure
3 - hypovolaemia /haemorrhage
4 - increases SVR

Answer 6

2 - increased intrathoracic pressure
- tension pneumothorax

3 - hypovolaemia /haemorrhage

Question 7

Which 2 of the following can cause cardiac shock?

1 - Supraventricular tachycardia
2 - AF
3 - cardiac injury /contusion
4 - cardiac failure

Answer 7

3 - cardiac injury /contusion

4 - cardiac failure
- potentially due to ischaemic event due to trauma

Question 8

Which 2 of the following can cause afterload shock?

1 - septic shock
2 - increased intrathoracic pressure
3 - neurogenic shock
4 - increases SVR

Answer 8

1 - septic shock

3 - neurogenic shock
- spinal injury reduces sympathetic tone and causes vasodilation

Question 9

Which of the following is NOT given when patients lose a lot of blood?

1 - whole blood
2 - WBC
3 - platelets
4 - clotting factors

Answer 9

2 - WBC

Question 10

Which of the following drugs can be given in trauma to significantly reduce the risk of death if given within 3 hours?

1 - Edoxaban
2 - Apixaban
3 - Tranexamic Acid
4 - Rivaroxaban

Answer 10

3 - Tranexamic Acid

Question 11

Tranexamic Acid is a drug given in trauma to significantly reduce the risk of death if given within 3 hours. What is the mechanism of action?

1 - inhibits factor Xa (10a)
2 - inhibits platelets
3 - inhibits plasminogen
4 - inhibits factor III

Answer 11

3 - inhibits plasminogen

• plasminogen is converted to plasmin which is anti- fibrinolytic
• this drug promotes hemostasis is the mechanism that leads to cessation of bleeding from a blood vessel

Question 12

What is the most commonly injured organ in the abdomen?

1 - spleen
2 - liver
3 - stomach
4 - pancreas

Answer 12

2 - liver

• bleeding can be life threatening

Question 13

If spleen is significantly damaged during blunt trauma what can this result in?

1 - immunocompromised
2 - hypotension
3 - catastrophic haemorrhage
4 - pancreas damage

Answer 13

3 - catastrophic haemorrhage

• depending on severity of damage a splenectomy may be required

Question 14

If the kidneys are injured following trauma, what can often be a sign of this?

1 - bleeding into the flanks
2 - blood around the umbilicus
3 - haematuria
4 - polyuria

Answer 14

3 - haematuria

• generally need CT to diagnose

Question 15

When looking at pelvic injuries, which typically require a large force, does it typically break in one place?

Answer 15

• no
• typically breaks in more than one place
• think polo mint, cannot break in just one place