Test 31 - Surgery

Question 1

What are the signs of herniation?

Answer 1

HTN, bradycardia, respiratory depression (Cushing’s triad)

Question 2

What nerve is usually compromised when a patient has a transtentorial herniation?

Answer 2

Oculomotor
Signs: ipsilateral hemiparesis, ipsilateral mydraisis (dilated pupil) and strabismus, contralateral hemianopsia, altered mental status

Question 3

Tetanus prophylaxis in clean minor v dirty major wound

Answer 3

If fully vaccinated:
Clean minor: give booster (dtap toxoid vaccine) if last dose was over 10 years ago
dirty major: give booster if last dose was over 5 years ago

If not vaccinated
Clean: give booster
Dirty: give booster and immunoglobulin

Question 4

Supracondylar fractures of the humerus: MOA, comlications

Answer 4

MOA: fall on an outstretched hand (in kids)
Complications: entrapment of the brachial artery (px w loss of brachial and radial pulses) or median nerve

Question 5

What is the prefered test for biliary stones?

Answer 5

Ultrasound, CT only catches it 50% of the time