Trauma

Question 1

Spleen injury

Answer 1

LUQ pain that radiates to L shoulder (Kehr’s sign)

Question 2

DIC Laboratory findings

Answer 2

Elevated fibrin degradation products, D-dimer, prolonged PT, PTT, decreased platelets, fibrinogen

Question 3

Tension pneumothorax - findings and TX

Answer 3

Intrathoracic pressure increases d/T air entering space but not being able to leave. Subsequently decreasing BP d/T a decrease in CO d/T a decrease in venous return d/T the increase in pressure in the cavity. Emergent needle decompression for TX.

Question 4

MS Injuries : depolarizing or nondepolarizing agent for RSI?

Answer 4

Nondepolarizing, such as Rocironium. The fasiculations May cause further MS injury.
Succinylcholine is a depolarizing agent.

Question 5

Rules of nines - burns

Answer 5

18% anterior torso
18% posterior torso
9% head
9% each upper extremity (a+p)
18% each upper extremity (a+p)
1% perineum

Question 6

Lefort II FX

Answer 6

Pyramidal - middle of the face. Begin at nasal bone and separates nose and upper palate from the rest of the face. Severe epistaxis, periorbital swelling/ecchymosis, rhinorrhea, paraesthesia of the cheek.

Question 7

Le Fort III FX

Answer 7

Complete craniofacial disjunction - complete separation of facial bones from cranial attachment. Same signs as a Le Fort II plus facial lengthening, hooding of eyes, enophthalmos.

Question 8

Blood loss volume from femur FX

Answer 8

1 to 1.5L

Question 9

Consensus Formula

Answer 9

2 to 4 mL/kg/% TBSA. From time of burn injury give half of this amount of fluid in the first 8 hours. The second half over 16 hours. UOP goal of 0.5 and 1ml/kg/h

Question 10

Normal carbon monoxide levels

Answer 10

<2%

Question 11

When UOP goal isn’t reached w/ burn PT, management includes:

Answer 11

Adding 12.5g of Mannitol to each liter of fluid administered. An osmotic diuretic that pulls interstitial fluid into the vascular space - perfusing the kidneys and increasing GFR

Question 12

First, second, third degree burns

Answer 12

1st: Superficial partial thickness
2nd: Deep partial thickness
3rd: Full thickness

Question 13

Smell of garlic on PT’s breath

Answer 13

Organophosphate poisoning

Question 14

What is a sign of renal trauma?

Answer 14

Grey Turner’s sign

Question 15

Organ commonly injured as a result of shock wave

Answer 15

Overpressure injuries occur in air filled organs such as the lungs

Question 16

Initial fluid resuscitation of hypotensive trauma PT?

Answer 16

1-2L NS IV

Question 17

Cranial nerve that tests gag reflex

Answer 17

Vagus

Question 18

Clotting factors used in hemophilia PT

Answer 18

Factor VIII and IX

Question 19

Injury most common in a restrained driver

Answer 19

Pelvic FX’s

Question 20

Treatment for adrenal crisis

Answer 20

IV cortisone and NS