Surgery

Question 0

Alcoholic 67 yo male with lethargy, confusion, temp of 34 degrees C, EKG: Vtach and J waves.
-Dx?

Answer 0

Hypothermia

Question 1

RFs and mortality (%) for burn patients

Answer 1

RFs:
Age > 60 yo
>40% BSA burned
Inhalation injury (increased COHb)

0 = 0.3% chance of dying
1 = 3% 
2 = 33%
3 = 90% (all 3 RFs = death)

Question 2

Difference between heat exhaustion vs heat stroke

Answer 2

Heat Exhaustion: normal labs, sweating, Tx: PO fluids, replace electrolytes

Heat Stroke:

• End organ failure (labs abnormal), NO sweating
• Tx: external cooling and benzos if Sz

Question 3

Tx for dog bites vs cat bites

Answer 3

Dog: iodine & irrigation, no ABX
Cat: iodine & irrigation + Amox/Clav
(Cat=pasteurella multocida)

• suture face bites (low infxn risk)
• don’t suture hand bites
• psych f/u for children
• tetanus

Question 4

Human bite treatment

Answer 4

Iodine and irrigation
+
Amox/Clav
(covers anaerobes and aerobes)

Question 5

Patient presents with tachycardia, bleeding from a bite, increased Bleeding Time and PT,
+D-Dimer
Low fibrinogen
-cause?

Answer 5

DIC 2/2 snake or spider bite

Question 6

Tetanus immunization schedule

Answer 6

Children:
DTaP: 5 doses from Birth-7yo
Tdap booster at 11/12yo

Adults:
Tdap booster FIRST b/t 19-64yo
THEN
Td q10

Question 7

When to give tetanus Ig in addition to Td series (3 shots)

Answer 7

tetanus wound (rusty metal)
dirty wounds
uknown vaccination history