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ER COMAT > Trauma > Flashcards

Trauma Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

History of blunt abdominal trauma or infection, leukemia, inflammation, medication. Pt will present with diffuse abdominal pain, especially in the LUQ, possible guarding. Delayed hemorrhagic shock is possible. What is the most likely diagnosis?

A

Spleen injury

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2
Q

History of blunt abdominal trauma or infection, leukemia, inflammation, medication. Pt will present with diffuse abdominal pain, especially in the LUQ, possible guarding. Delayed hemorrhagic shock is possible. If the patient is hemodynamically unstable, what is your first step?

A

Ultrasound

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3
Q

History of blunt abdominal trauma or infection, leukemia, inflammation, medication. Pt will present with diffuse abdominal pain, especially in the LUQ, possible guarding. Delayed hemorrhagic shock is possible. If the patient is hemodynamically stable, what is your first step?

A

abdominal CT with contrast

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4
Q

History of blunt abdominal trauma or infection, leukemia, inflammation, medication. Pt will present with diffuse abdominal pain, especially in the LUQ, possible guarding. Delayed hemorrhagic shock is possible. How do you treat?

A

laparotomy

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5
Q

History of blunt abdominal trauma. Pt will present with referred pain to the right shoulder and ecchymoses over the lower right chest or RUQ. What is the most likely diagnosis?

A

Liver injury

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6
Q

History of blunt abdominal trauma. Pt will present with referred pain to the right shoulder and ecchymoses over the lower right chest or RUQ. If the patient is hemodynamically unstable, what is your first step for diagnosis?

A

Ultrasound

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7
Q

History of blunt abdominal trauma. Pt will present with referred pain to the right shoulder and ecchymoses over the lower right chest or RUQ. If the patient is hemodynamically stable, what is your first step for diagnosis?

A

Abdominal CT scan with contrast

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8
Q

History of blunt abdominal trauma. Pt will present with referred pain to the right shoulder and ecchymoses over the lower right chest or RUQ. If the patient is hemodynamically unstable, what is your first step in treatment?

A

Laparotomy

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9
Q

Sudden onset dyspnea, ipsilateral, pleuritic chest pain, sinus tachycardia, ipsilateral decreased breath sounds, hyper resonance to percussion. What is the most likely diagnosis?

A

Spontaneous pneumothorax

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10
Q

Sudden onset dyspnea, hypotension, tracheal deviation. What is the most likely diagnosis?

A

Tension pneumothorax

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11
Q

Sudden onset dyspnea, ipsilateral, pleuritic chest pain, sinus tachycardia, ipsilateral decreased breath sounds, hyper resonance to percussion. What is your first step in diagnosis?

A

Chest X Ray

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12
Q

Sudden onset dyspnea, ipsilateral, pleuritic chest pain, sinus tachycardia, ipsilateral decreased breath sounds, hyper resonance to percussion. How do you treat?

A

Immediate needle decompression and/or tube thoracostomy

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13
Q

Where do you perform a needle decompression?

A

2nd intercostal space just above the rib or the 4th intercostal space just above the rib at the anterior axillary line

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14
Q

Local pain on pressure, percussion and compression, paravertebral hematoma, weakness or numbness/tingling, neurogenic shock. Paralysis is possible. What is the most likely diagnosis?

A

Vertebral fracture

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15
Q

Local pain on pressure, percussion and compression, paravertebral hematoma, weakness or numbness/tingling, neurogenic shock. Paralysis is possible. What diagnostic tests should you perform?

A

A detailed near exam, a rectal exam to assess for sphincter tone, and an X ray

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16
Q

Local pain on pressure, percussion and compression, paravertebral hematoma, weakness or numbness/tingling, neurogenic shock. Paralysis is possible. What is the treatment?

A

Conservative treatment for stable patients. For unstable patients, surgical treatment may be necessary

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17
Q

Bilateral paresis, upper extremities affected more than lower extremities

A

Central cord syndrome

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18
Q

What tracts are affected in central cord syndrome?

A

bilateral central corticospinal tracts and lateral spinothalamic tracts

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19
Q

Bilateral motor paralysis, loss of pain and temperature sensation and autonomic dysfunction below the level of the lesion

A

Anterior cord syndrome

20
Q

What tracts are affected in anterior cord syndrome?

A

Corticospinal tracts and spinothalamic tracts

21
Q

Bilateral loss of proprioception, vibration, and touch sensation below the level of the lesion

A

Posterior cord syndrome

22
Q

What tracts are affected in posterior cord syndrome?

A

Posterior columns

23
Q

Ipsilateral loss of proprioception, vibration, and tactile discrimination below the level of the lesion, contralateral loss of pain and temperature sensation one or two levels below the lesion

A

Brown-Sequard syndrome

24
Q

Paraplegia, areflexia, loss of bowel and bladder control. What is the most likely diagnosis?

A

Spinal shock

25
Q

Impaired sensation, spastic paresis, hyperreflexia, pathological reflexes, neurogenic bladder, autonomic dysreflexia. What is the most likely diagnosis?

A

Complete spinal cord syndrome

26
Q

Impaired sensation, spastic paresis, hyperreflexia, pathological reflexes, neurogenic bladder, autonomic dysreflexia. How do you diagnose?

A

CT

27
Q

What is autonomic dysreflexia?

A

HTN, throbbing headache, flushing, paleness, bradycardia. Medical emergency.

28
Q

Who is at risk for autonomic dysreflexia?

A

Those with spinal cord injuries at T6 or above.

29
Q

Severe shoulder pain, inability to move shoulder, empty glenoid fossa. What is the most likely diagnosis?

A

Shoulder dislocation

30
Q

Severe shoulder pain, inability to move shoulder, empty glenoid fossa. What are the next steps in diagnosis?

A

X-ray

31
Q

Severe shoulder pain, inability to move shoulder, empty glenoid fossa. How do you treat this?

A

Immobilization, closed reduction. Surgery indicated if reduction is unsuccessful.

32
Q

Sagging of the shoulder, tenting of skin over clavicle, shortening of clavicle. What is the most likely diagnosis?

A

Clavicle fracture

33
Q

Sagging of the shoulder, tenting of skin over clavicle, shortening of clavicle. What are the next steps in diagnosis?

A

X Ray

34
Q

Sagging of the shoulder, tenting of skin over clavicle, shortening of clavicle. How do you treat?

A

Midshaft fracture: mostly conservative
Lateral fracture: surgery

35
Q

Severe upper arm pain, shortening of the arm, swelling, neuromuscular complications possible. What is the most likely diagnosis?

A

Humerus fracture

36
Q

In the case of radial head subluxation, the pt will hold their arm _____.

A

flexed and pronated

37
Q

distal radius and distal ulna fracture

A

Colles fracture

38
Q

distal radius

A

Smith fracture

39
Q

pelvic pain caused by movement, weightbearing and compression of the iliac crests, tilted pelvis and unequal leg length. pelvic instability, labial, scrotal, flank, and inguinal hematomas. What is the most likely diagnosis?

A

Pelvic fracture

40
Q

pelvic pain caused by movement, weightbearing and compression of the iliac crests, tilted pelvis and unequal leg length. pelvic instability, labial, scrotal, flank, and inguinal hematomas.What is the best diagnostic test?

A

Pelvic X-ray

41
Q

Impaired consciousness, confusion, headache, contralateral hemiparesis, crescent shaped concave lesion that crosses suture lines

A

Subdural hematoma

42
Q

Initial loss of consciousness immediately following head injury, temporary recovery of consciousness with return to normal or near-normal neurological function, biconvex lesion that is limited by suture lines

A

Epidural hematoma

43
Q

What vessels are involved in a subdural hematoma

A

bridging veins

44
Q

What vessel is involved in an epidural hematoma?

A

middle meningeal artery

45
Q

pain out of proportion to physical findings, persistent deep ache or burning pain, paresthesia, pain with passive movement, swelling, decreased sensation. Most likely diagnosis?

A

Acute compartment syndrome

46
Q

pain out of proportion to physical findings, persistent deep ache or burning pain, paresthesia, pain with passive movement, swelling, decreased sensation. Treatment?

A

fasciotomy

ER COMAT (13 decks)

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