TRAUMA

Question 1

Fluid resuscitation in electrical burns

Answer 1

4ml x % burns x weight in kg RL/HARTMAN

half over 8 hours
rest over 16 hours

Question 2

Fluid resuscitation in child with burns

Answer 2

3ml x % burns x weight in kg RL

half over 8 hours
rest over 16 hours

Question 3

fluid resuscitation in adult with deep partial and full thickness burns

Answer 3

2ml x % Burns x weight in kg RL

HALF OVER 8 and rest over 16 hours

Question 4

target urine output in burns

Answer 4

Adult 0.5ml/kg/hour
child 1ml/kg/hour

Question 5

referrals for burns

Answer 5

burns at extremes of ages
partial thickness burns >2%TBSA
full thickness all
FACE, HANDS FEET , GENITALIA, PERINEUM, MAJOR JOINTS
Circumferential burns of limbs and chest
electrical and chemical burns
ass. inhalational injury
trauma
major comorbidities
all burns >3% in adults and 2% in children

Question 6

acl tear

Answer 6

valgus stress , flexed knee twisting force
pop is heard
immediate swelling (geniculate arteries run within ligament)
large haemarthrosis
physio if inactive
surgical ligament reconstruction if active

Question 7

meniscal tear

Answer 7

locked knee with swelling hours after injury
mode flexed knee externally or internally rotated

Question 8

ACL AND PCL

Answer 8

acl attached to lateral condyle
pcl medial condyle of femur

Question 9

Pcl tear

Answer 9

blunt force trauma to flexed knee

Question 10

quadriceps tendon rupture

Answer 10

basketball player
high axial load
awkward landing on one leg with foot planted in partial flexion of kneee

Question 11

types of burns

Answer 11

1. superficial - epidermis , skin red and painfull but not blistered
2. superificial partial thickness - epidermis + superficial dermis, red and blotchy skin with swelling and blisters, very painfull hypersensitive
3. deep partial thickness- epidermis +dermis , skin pale with small blisters, may not cause much pain. pressure feeling
4. full thickness- epidermis + dermis + s/c fascia
   waxy skin painless

Question 12

o donoghues unhappy triad

Answer 12

acl rupture
mcl rupture
medial meniscus tear

Question 13

tetanus prone burn wound

Answer 13

surgery needed but cannot be done in 24 hours
significant tissue removed, puncture type, animal bite, soil contamination

Question 14

u/l non functioning IVU

Answer 14

1. absent kidney
2. thrombosis/avulsion of renal artery
3. parenchymal disruption

Question 15

massive hemothorax

Answer 15

> 1500 ml blood on chest drain or 200ml/hr for 2-4 hours
mx- thoracotomy

Question 16

crush syndrome

Answer 16

hyperkalemia
hypocalcemia
coagulopathy
myoglobinaemia
anuric renal failure
uraemia
haemoconcentration

Question 17

healing by secondary intention

Answer 17

granulation
epithelialisation.
wound contarction

grossly contaminated wounds
wounds with extensive tissue loss
surgical wounds like laprostomy

Question 18

primary closure

Answer 18

suturing
stapling
steri strips

Question 19

deltoid ligament

Answer 19

medial ligament of ankle
twisting injury

inversion injury
lateral ligament if ankle
ankle sprain

Question 20

flexor tendon injury zones

Answer 20

1. bw dipj crease and middle phalanx, distal to insertion of fds
2. bw 1 and distal palmar crease
   3.bw 2 and distal margin of carpal tunnel
3. over carpal tunnel
4. forearm and wrist

Question 21

gardens classification

Answer 21

intracapsular fracture nof

1. undisplaced incomplete, valgus impacted
2. undisplaced complete
3. complete, incompletely displaced
4. complete , completely displaced

Question 22

weber fracture

Answer 22

lateral malleolar fracture
classified in relation to distal tibio fibular syndesmosis

A. infrasyndesmotic
B. trans syndesmotic
C. suprasyndemotic

Question 23

le fort fractures

Answer 23

maxilla fracture classification.

1. passes through — base of pyriform aperture, maxillary sinus and pterygoid plate

2.

3. midcraniofacial dissociation

Question 24

urethral injury in pelvic fracture inv

Answer 24

unable to void
requires a pelvic binder
blood at the meatus
scrotal hematoms
perineal echymosis

inv retrograde urethrography
mx suprapubic catherterisation

Question 25

zones of penetrating neck injury

Answer 25

1. clavicle to cricoid
2. angle of mandible
3. base of skull