Surgery

Question 1

vasopressor used for neurogenic shock

Answer 1

Phenylpherine

Question 2

Warm shock

Answer 2

Neurogenic - disterbutive

Question 3

Mx of inhalation injury

Answer 3

elective intubation

Question 4

complication of smoke inhalation

Answer 4

mucosal edema

Question 5

indication for cricothyrodotomy

Answer 5

mandibular fracture, bloody “can’t visulize”, failure to intubate 3x

Question 6

compensated shock sx

Answer 6

cold + pale

Question 7

first thing to change b/w compensated & decomp

Answer 7

BP

Question 8

indication for intubation to neck injury

Answer 8

stridor
expanding hematoma
respiratory injury

Question 9

zones of the neck

Answer 9

above mandibular: zone 3
below cricoid: zone 1
between is 2

Question 10

hard signs

Answer 10

• hematemesis
• emphysema
• air bubble
• stroke
• active bleed
• pulsatile/expanding hematoma

Question 11

hard signs mx

Answer 11

neck exploration

Question 12

stable patient with soft signs

Answer 12

CT scan

Question 13

Stable patient with CT scan showing damage to the trachea or esophagus. next

Answer 13

bronchoscope - endoscope

Question 14

Stable patient with CT scan showing damage to the vessles next

Answer 14

aortgram

Question 15

intrathroacic major vessles in which zone of neck

Answer 15

1

Question 16

mx of flail chest

Answer 16

• pain control (opioid) + Physiotherapy
• mechanical ventilation (PEEP 10-15)
• Surgery

Question 17

what causes resp sx in flail chest

Answer 17

pulmonary contusion

Question 18

tensoin pneumothorax. clinical or radiological dx?

Answer 18

clinical

Question 19

tensions pneumothorax. best mx

Answer 19

chest tube

Question 20

tensions pneumothorax. next mx

Answer 20

needle decompression

Question 21

size of needle in tensions pneumothorax

Answer 21

large needle 14gauge

Question 22

tracheo-bronchial fistula mx

Answer 22

• if pt intubated: ask anesthesia to re-intubate in opposite site of leakage
• if pt NOT intubated: add second chest tube

Question 23

CXR showing large pneumothorax after insertion of chest tube, patient is dypsnic. dx?

Answer 23

tracheo-bronchial fistula

Question 24

cardiac margins for cardiac contusion

Answer 24

costal margin - clavicle - midclavicular lign

Question 25

becks triad for cardiac temponade

Answer 25

hypotension - jvp distended - muffled heart sound

Question 26

blunt cardiac injury algorithm

Answer 26

do fast scan

• if positive check –> BP: hypotensive patient go surgery w/sternotomy
• if negaticve –> Repeat ecg and tropnoin

Question 27

penetrating cardiac injury + arrest

Answer 27

thoractomy

Question 28

penetrating cardiac injury + positive fast

Answer 28

no need to check BP, do sternotomy immidiatly

Question 29

penetrating cardiac injury + negative fast

Answer 29

check pneumothorax, spinal injury, hemothorax

Question 30

JVP in hemothroax

Answer 30

flat

Question 31

findings of aortic injury

Answer 31

widned mediastinum - apical capping - loss of aortopulmo window - tracheal deviation - 1st & 2nd rib frature - left hemothorax

Question 32

site of aortic injury

Answer 32

ligamentum arteriosum distal to subclavian injury

Question 33

thoraco-abdominal injury to assess if there’s diaphragmatic reigon with sign of peritoneal violation–> inv?

Answer 33

diagnostic laproscopy

Question 34

indications for immediate laparotomy

Answer 34

peritonitis - evisceration - hypotension - GI bleeding

Question 35

trauma + injury + unstable

Answer 35

Fast —> +Ve lapro / -ve dpl

Question 36

trauma + injury + stable

Answer 36

FAST –> +ve CT/ -ve examine

Question 37

contraindication of wound exploration

Answer 37

agitation - unstable - morbid obese

Question 38

stab in ant. abomen + 1cm laceration + stable + best mx

Answer 38

CT scan