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Medicine Finals: HARD STUFF ONLY > Random Misc e.g. Trauma > Flashcards

Random Misc e.g. Trauma Flashcards

1
Q

When might you want to do jaw thrust over a head tilt chin lift?

A

In a patient where cervical spine injury is a concern

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2
Q

Which airway protects against aspiration?

A

Endotracheal tube

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3
Q

Which airway is CI in base of skull fracture?

A

Nasopharyngeal airway

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4
Q

Which airway is most common operatively?

A

Oropharyngeal airway

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5
Q

How can you assess the extent of a burn?

A 
Rule of Nines
Head + Neck = 9%
Each Arm = 9%
Front of chest = 9%
Front of abdomen = 9%
Back of chest = 9%
Back of abdomen = 9%
Front of leg = 9%
Back of leg = 9%
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6
Q

How can you assess the depth of a burn?

A

Red and painful = first degree (superficial epidermal)

Pale pink/blistered = second degree (superficial dermal)

White + reduced sensation = second degree (deep dermal)

White/brown/black, no pain = third degree (full thickness)

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7
Q

Who needs referral to secondary care for a burn?

A

All deep dermal + full thickness (any that are white or reduced sensation)

Any superficial dermal of more than 3%
Any superficial dermal involving hands/face/feet/perineum/genitalia
Any inhalation injury or burn caused by electrical/chemical

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8
Q

How to initially manage a burn?

A

Superficial epidermal = symptomatic relief and emollients only
Superficial dermal = cleanse wound, leave blister intact

In more severe burns - consider intubation and inserting a Catheter (basically do an A-E)

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9
Q

Who requires IV fluids for burns? How is the amount of fluid calculated?

A 
Child = burns more than 10%
Adult = burns more than 15%

Volume of fluid = burn surface area (%) x weight x 4
Half of this fluid should be given in first 8 hours

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10
Q

What are red flag signs of head injury?

A 
Impaired consciousness
Fixed + dilated pupils
Base of skull fracture
FOcal neurological deficit
Seizures/Amnesia
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11
Q

What are the indications for a CT head after a head injury?

A 
GCS <13 at time of arrival
GCS <15 after 2 hour
Any signs of skull fracture
Seizure 
More than one episode of vomiting
Focal neurological deficit
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12
Q

How do you assess brainstem death?

A 
Need to check all brainstem reflexes
Pupillary light reflex
Corneal reflex
Pain stimuus
Gag reflex
Cough reflex
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13
Q

What is a diffuse axonal injury and how can you diagnose it?

A

Type of traumatic brain injury not seen on CT

Need to do head MRI

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14
Q

How is a tibial shaft fracture managed?

A

Realign ASAP - ideally in A+E under analgesia
Then above the knee backslab

Repeat XR after manipulation

THen likely need definitive surgical management with intramedullary nailing

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15
Q

What is the main complication of a tibial shaft fracture?

A

High risk of compartment syndrome

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16
Q

How is a suspected cervical fracture investigated and managed?

A

In adults = CT scan
In children = MRI scan

C spine immobilisation with a collar

DO NOT DO A HEAD TILT/CHIN LIFT!

17
Q

How do you manage a suspected pelvic fracture?

A

Do a full neuromuscular assessment and check anal tone
Need to get 3 x-rays

Do a primary survey and put in a pelvic binder

Complications = urological injury/VTE

18
Q

What are red flag signs for a base of skull fracture? How can it be diagnosed?

A 
Traumatic head injury e.g. RTC
Reduced consciousness
bruising around the eyes
rhinorrhoea - possibly leaking CSF
cranial nerve palsy
bleeding from nose or ears

CT head required

DO NOT INSERT NASOPHARYNGEAL AIRWAY!

19
Q

What is pre-operative fracture management?

A
  • Effective analgesia
  • Reduction of deformity
  • Irrigation and debridement of open fractures
  • Administration of antibiotics where indicated
  • Immobilisation of fracture
20
Q

What are the two types of urethral injury?

A

Bulbar rupture and membranous rupture

21
Q

What are the features of a bulbar rupture of the urethra?

A
  1. Urinary retention
  2. Perineal haematoma
  3. Blood at the meatus
22
Q

What are the features of a membranous rupture of the urethra?

A

Penile/perineal oedema or haematoma

PR will show upwards displacement of prostate

23
Q

How can you investigate urethral injury?

A

Ascending urethrogram

24
Q

How can you manage a urethral injury?

A

Suprapubic catheter

25
Q

What are signs of a bladder injury? How can you investigate this?

A

Haematuria + suprapubic pain

Cystogram

26
Q

What are features of acute urinary retention?

A

Acute suprapubic pain
Unable to pass urine
Palpable distended bladder

27
Q

How should you investigate acute urinary retention? How is it managed?

A

PR + post-void bladder scan

May need to do an ultrasound to assess for hydronephrosis

management = immediate catheterisation
If hydronephrosis then nephrostomy may be needed(?)

28
Q

What is the main complication of draining an acute bladder retention?

A

Post-obstructive diuresis

When there was a large retention volume
AKI after urinary retention
need to monitor urine output closely

Medicine Finals: HARD STUFF ONLY (23 decks)

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