Orthopedic Emergencies Flashcards

1
Q

focused assessment for trauma with sonography. finds blood around heart and abdominl organs

A

FAST scan

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2
Q

Decreases pelvic volume promoting tamponade. Prevents shifting of the fractures which causes more bleeding.

A

stabilize pelvis with external fixator

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3
Q

muscle breakdown products which can cause renal failure

A

rhabdomyolysis

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4
Q

At which joints do vessels and nerves go through tight spaces?

A

elbow and knee

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5
Q

Describe a class 1 open fracture

A

puncture wound, minimal signs of contamination

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6
Q

Describe a class 2 open fracture

A

open fracture with minimal soft tissue damage and contamination

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7
Q

Describe a class 3 open fracture

A

grossly contaminate wound with little skin coverage

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8
Q

When should you not close a bite wound?

A

if on hands and feet, crush injuries, deep punctures

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9
Q

When should you close a bite wound?

A

if on face, not infected, less than 24 hours

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10
Q

What abx should you use as prophylaxis for a cat bite, deep puncture, crush injury, or hand wound?

A

Amoxicillin clavulanate

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11
Q

What pathogen do you need to worry about with nail puncture wounds and can be treated with cipro?

A

pseudomonas

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12
Q

What is used to fill the defect left by tumor resection and operative fixation of an impending fracture from a tumor?

A

methylmethacrylate

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13
Q

Elevated interstitial pressure prevents muscle capillary flow. Ischemia in the compartment causes severe pain

A

acute compartment syndrome

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14
Q

Where does acute compartment syndrome occur most often?

A

in lower leg and forearm Fx’s

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15
Q

What is the most sensitive test for acute compartment syndrome?

A

pain with passive stretch of the muscles

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16
Q

What should you NOT do when treating compartment syndrome?

A

elevate the part

17
Q

What is the definitive treatment of acute compartment syndrome?

A

fasciotomy

18
Q

Seen in pelvic and long bone Fx’s, closed more than open. Clinical syndrome: pulmonary distress, CNS changes, petechiae. 72 hrs post injury

A

fat embolism syndrome

19
Q

What is the prophylaxis for fat embolism syndrome that should be considered in closed pelvic and long bone Fx’s?

A

Low dose steroids

20
Q

6 hours after ORIF for a supracondylar elbow fracture your patient complains of increasing arm pain. He has marked pain with passive dorsiflexion of his fingers. What do you do next?

A

measure compartment pressures

21
Q

3 days after a femoral fracture your patient becomes confused and
short of breath. How do you treat him/her?

A

respiratory support

22
Q

6 days after an open ankle fracture treated with surgery your patient complains of increasing wound pain and feels sick. What do you do?

A

wound inspection –antibiotics

23
Q

10 days after rodding a femoral fracture you patient complains of
pleuritic chest pain and shortness of breath. How do you handle this?

A

anticoagulants and respiratory support

24
Q

What is the most important treatment in open fracture?

A

initiation of abx

25
Q

What it the protocol for someone who has an open fracture and isn’t up to date on their tetanus?

A

give tetanus antibody as well as antigen in opposite areas of the body

26
Q

What should every patient who has an injury related to farming be given for abx?

A

penicillin G

27
Q

What is the most sensitive clinical sign for compartment syndrome?

A

pain out of proportion to the injury

28
Q

What are the 5 P’s of compartment syndrome?

A

Pain, Pulse, Pallor, Paralysis, Paresthesia

29
Q

What value of a hand held monometer is too high to allow for capillary perfusion (ie compartment syndrome)?

A

value is within 30mmHg of the patients diastolic pressure

30
Q

What is the difference between Colles and Smith fractures?

A

Colles is displaced dorsally whereas Smith is displaced volarly

31
Q

fracture of the radius with dislocation of the distal radioulnar joint

A

Galeazzi fracture

32
Q

a fracture of the proximal third of the ulna with dislocation of the head of the radius

A

Monteggia fracture

33
Q

a fracture of the distal third of the humerus resulting in entrapment of the radial nerve.

A

Holstein-Lewis fracture

34
Q

a spiral fracture of the proximal third of the fibula associated with a tear of the distal tibiofibular syndesmosis and the interosseous membrane

A

Maisonneuve fracture