Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery Clerkship > Trauma > Flashcards

Trauma Flashcards

1
Q

First step when assessing trauma?

A

ABCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How to tell if airway patent vs urgent vs emergent

A

Patent if patient is speaking in full sentences, bilateral breath sounds
Urgent if impending airway collapse like expanding hematoma or cutaneous emphysema
Emergent intubation if gurgling, stridor, GCS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Goal RR when assessing trauma

A

12-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Stepwise escalation in breathing for patient

A

Supplemental O2, Bag mask, ET tube, cricothyrotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Signs of circulatory shock?

A

SBP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Equation to determine MAP?

A

MAP=COxSVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How to determine CO?

A

CO=HRxSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How to determine SV?

A

Preload x contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Conditions that decrease preload?

A

Hemorrhage or obstruction (pericardial tamponade/tension pneumothorax).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How to diagnose hemorrhage?

A

FAST (focused assessment with sonography for trauma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to treat hemorrhage?

A

2 large bore IVs, IVF, type and screen, give blood, fix the hole.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Patient presentation with tension pneumo?

A

Engorged neck veins, absent lung sounds, deviated trachea, hyperresonant cavity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment for tension pneumo

A

Immediate needle decompression at anterior second intercostal space.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Patient presentation with percardial tamponade?

A

Engorged neck veins, clear lungs, distant heart sounds, hypotension, pulsus paradoxus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How to diagnose pericardial tamponade?

A

FAST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How to treat pericardial tamponade?

A

Pericardiocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Signs and cause of basilar skull fracture

A

Significant trauma causes raccoon eyes or battle sign. Perhaps CSF leak from ear or nose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How to diagnose basilar skull fracture

A

CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does an epidural hematoma occur?

A

Side of head trauma causes middle meningial artery bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does patient with epidural hematoma present?

A

Unconscious -> lucid interval -> death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How to diagnose epidural hematoma?

A

Lens shape on CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Treatment for epidural hematoma

A

Craniotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What type of patients get acute subdural hematomas?

A

Shaken babies or teens in a HUGE trauma like an MVA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How to diagnose subdural hematoma?

A

CT scan shows crescent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How to treat a patient with subdural hematoma?

A

Decrease intracranial pressure so elevate head of bed, hyperventilate patient, give mannitol.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What type of patients get chronic subdural hematomas?

A

Elderly, alcoholics. Bridging veins tear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How to treat concussion?

A

Send patient home, keep patient awake so they don’t slip into coma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What types of patients get diffuse axonal injury?

A

Angular trauma, patient will slip into coma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How to diagnose diffuse axonal injury?

A

CT shows blurring of grey-white junction with punctate hemorrhages.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How to work up gsw to upper neck, middle neck, lower neck?

A

Upper neck - arteriogram
Middle neck - surgery
Lower neck - bronch, endoscopy, arteriogram

Then get a CT of the C-spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How to work up knife wound to upper neck, middle neck, lower neck?

A

Arteriogram and ultrasound to all three.

Then get a CT of the c-spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

When to go right to surgery after GSW or knife wound to the neck?

A

GSW to middle neck or any time a patient is gurgling, has a hematoma, and is in shock.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Spinal cord tracts DCML, pain+temp, motor

A

Pain and temp cross immediately, DCML and motor fibers cross in medulla. So injury on one side will affect ipsilateral proprioception and movement but contralateral pain and temp perception.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How to treat any cord syndrome with urinary or fecal incontinence or erectile dysfunction?

A

Immediate high dose dexamethasone. Diagnose with MRI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What types of patients get anterior cord lesion? What is the pathogenesis and what are the symptoms?

A

Elderly patients, patients in MVA. From hyperextension of neck.
Symptoms are paralysis and burning pain in extremities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What causes rib fractures?

A

Blunt trauma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Symptoms of rib fracture? Consequence of symptoms?

A

Chest pain and splinted breathing. Causes atelectasis and eventually pneumonia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How to treat rib fracture?

A

With pain control.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Signs of pneumothorax

A

Dyspnea, hyperresonant lung sounds, decreased breath sounds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How to diagnose pneumothorax?

A

CXR shows vertical lung shadow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

How to treat pneumothorax?

A

Thoracostomy at apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Signs of hemothorax

A

Dullness to percussion, dyspnea, decreased breath sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How to diagnose hemothorax?

A

CXR shows horizontal air fluid level.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How to treat hemothorax?

A

Thoracostomy at base of lung. Must check output to see if bleed is from peripheral vasculature or pulmonary vasculature.

If >1500 ml or >600cc/hour, then GO TO SURGERY.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How to treat a tension pneumothorax

A

Occlusive dressing taped x 3.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What causes flail chest?

A

Huge blunt trauma where 2 or more ribs break in 2 or more places.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How to tell if a patient has flail chest?

A

Paradoxical movement, breathing out causes segment to move in, viceversa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How to treat flail chest?

A

Weights/binders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How do patients get a pulmonary contusion?

A

Scapular fracture, sternal fracture, or flail chest.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What will the CXR show for pulmonary contusion?

A

CXR will be normal until 48 hours after the trauma at which point it will show bilateral white out.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Symptoms of pulmonary contusion?

A

Dyspnea, pulmonary edema.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

How to treat pulmonary contusion?

A

Avoid crystalloids, give colloids, PEEP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How to patients get a myocardial contusion?

A

Scapular fracture, sternal fracture, flail chest.

54
Q

How to diagnose myocardial contusion?

A

12 lead EKG and trop?

55
Q

How to treat myocardial contusion?

A

Prevent HF and treat arrhythmias. Give MONABASH

56
Q

How to patients get a traumatic aortic dissection?

A

Trauma causes aorta to rip of ligamentum arteriosum. Patient will be DOA or will have a adventitial hematoma.

57
Q

How to diagnose an aortic dissection?

A

Based on index of suspicion. Get a CXR. Then get CT scan, if negative and index of suspicion is still high, then get an angiogram.

58
Q

How to treat traumatic aortic dissection?

A

Surgical repair and decrease BP.

59
Q

How to treat GSW to abdomen?

A

Surgery, ex-lap

60
Q

How to treat knife wound to abdomen?

A

If evisceration, shock, or peritoneal signs present? Surgery

If not, probe the wound, if not through peritoneum, watch and wait. If though, surgery.

61
Q

How to diagnose blunt trauma?

A

FAST or CT, then take to surgery.

62
Q

How much blood can be stored in the body?

A

See book.

63
Q

Most common cause of bleeding after abdominal trauma?

A

Ruptured liver.

64
Q

Pathogenesis of ruptured liver?

A

Rips on ligamentum teres.

65
Q

How to stabilize a patient with ruptured liver?

A

Pringle maneuver.

66
Q

How to treat ruptured liver?

A

Repair or lobectomy.

67
Q

Which is more serious, ruptured spleen or ruptured liver?

A

Ruptured liver is more serious because spleen has a capsule, so can be repaired.

68
Q

What needs to be done to patients who have been splenectomized?

A

Vaccinate against encapsulated organisms.

69
Q

How to diagnose ruptured diaphragm?

A

Bowel sounds in chest. Patient also has Kehr’s sign which is pain referred to shoulder.

70
Q

Kehr’s sign

A

Pain referred to shoulder from ruptured diaphragm

71
Q

How do patients get pelvic trauma?

A

From a fall or an MVA

72
Q

How to diagnose pelvic trauma?

A

Hip rocking will cause extreme pain.

73
Q

How to treat pelvic fracture?

A

External fixation, will tamponade any vasculature that is bleeding. Do not open.

74
Q

Why are pelvic fractures so dangerous?

A

Because they are a gateway injury. Ureteral and urethral injuries can occur as a result.

75
Q

Urethral injury signs/ symptoms

A

Causes high riding prostate and blood at meatus.

76
Q

How to diagnose urethral injury?

A

Retrograde urethrogram.

77
Q

Place foley during urethral trauma?

A

NO WAY!

78
Q

How to diagnose ureteral injury?

A

IV pyelogram or methylene blue injection.

79
Q

What is a first degree burn?

A

Only epidermal involvement. Like a sunburn. Patient has erythema, lesion is warm and tender, no blisters.

80
Q

What is a second degree burn?

A

Epidermal and dermal involvement. Erythematous, tender, with blisters.

81
Q

What is a third degree burn?

A

Deeper than dermis, painless, surrounded by second degree burn. White or charred lesion.

82
Q

Which is a worse chemical burn? Alkali or acid?

A

Alkali

83
Q

How to treat a skin chemical burn?

A

Do not buffer, just irrigate like crazy

84
Q

How to treat a swallowed chemical burn?

A

Do not induce vomiting, can neutralize.

85
Q

How does a patient get a respiratory burn?

A

In a closed fire or explosion.

86
Q

How to tell a patient has a respiratory burn?

A

Soot on nostrils or mouth

87
Q

How to diagnose a respiratory burn?

A

Bronchoscopy

88
Q

How to treat respiratory burn?

A

Prophylactic intubation to prevent airway closure from laryngeal edema.

89
Q

What does an electrical burn do to patients?

A

Arrhythmias, heats up bones to cause rhabdo from muscle burn, posterior dislocation of shoulder.

90
Q

How to diagnose electrical burns?

A

CK and creatinine

91
Q

How to treat electical burns

A

IVF and mannitol to prevent kidney damage

92
Q

How to treat circumferential burn?

A

Eschar surrounds vascular supply and cuts it off. Treat by cutting eschar.

93
Q

Parkland formula

A

Rule of 9’s, 5050 8-16.

Head 9
Front chest 9
Back chest 9
Abdomen 9
Back abdomen 9
Leg 9 x2
Back of leg 9x2
Arm 9x2
Genitals 1

%BSAx4ccxKG + 2000

94
Q

How to treat burn

A

Early movement, early grafting pain control, sulfadiazine and mafenide ppx!

95
Q

Rabies algorithm

A

Animal bite, if wild, kill/capture.
If not wild, observe.

If animal has rabies or isn’t caught, give vaccine and igg, if not, do nothing.

96
Q

How to treat bee sting?

A

Give subq epinephrine 1:1000 if in anaphylaxis with H1 and H2 blockers.

If not in anaphylaxis, remove stinger.

97
Q

How to tell if snake is venomous?

A

If slit like eyes, if rattles, cobra cowl.

98
Q

How to tell if a snake is venomous from just looking at the bite?

A

If skin changes color, if erythematous, if patient has severe pain.

99
Q

How to treat snake bite?

A

Antivenom

100
Q

Symptoms of black widow spider bite?

A

Bite and severe abdominal pain. Can cause pancreatitis.

101
Q

How to treat black widow spider bite?

A

IVF, keep iv calcium nearby just incase of life threatening hypocalcemia from saponification.

102
Q

Brown recluse spider bites happen when…

A

Southern us, in attic with boxes.

103
Q

How to brown recluse spider bites appear?

A

Necrotic ulcer with ring erythema.

104
Q

How to treat brown recluse spider bite?

A

Debridement over and over and over.

105
Q

When to be suspicious of human bite?

A

Shady story, fight, sex act.

106
Q

How to treat human bite?

A

Debridement, exploration, irrigation, amoxicillin.

107
Q

How to secure airway in patient with neck emphysema?

A

Fiberoptic laryngoscope

108
Q

How to treat penetrating injury of skull?

A

Go to surgery

109
Q

How to treat skull fracture with closed wound?

A

No surgery

110
Q

How to treat skull fracture with open wound

A

Close the wound.

111
Q

Who has anterior cord syndrome?

A

People with vertebral burst fracture or syrinx.

112
Q

How to treat rib fracture?

A

Nerve block

113
Q

Type of injury that causes aortic rupture?

A

Deceleration injury.

114
Q

How do air embolisms occur?

A

In a respirator patient or if subclavian vein is open to air (like during an LN biopsy, central line).

115
Q

How to treat air embolism

A

Cardiac massage in L lateral decub

116
Q

How to prevent air embolism

A

Put patient in trendelenberg

117
Q

Symptoms of fat embolism

A

Long bone fracture with axillary petechial rashes, low platelets, and respiratory collapse.

118
Q

How to prevent intraoperative coagulopathy?

A

FFP and platelets

119
Q

How to treat patient with intraoperative coagulopathy, hypothermia, and acidosis?

A

Stop laparotomy, pack wounds, and close until coagulopathy and hypothermia are treated

120
Q

Abdominal compartment syndrome. Treatment?

A

When tissues are swollen after lap and prevent closure. Abdominal Mesh is treatment

121
Q

How to treat abdominal compartment syndrome if it presents on PO day 2 with hypoxia and renal failure?

A

Open abdominal wound.

122
Q

How to treat leaky bladder after injury?

A

Surgical repair and suprapubic cystomy.

123
Q

How to treat penis fracture? Consequence of not treating?

A

Emergency surgical repair, otherwise impotence can ensue.

124
Q

First step in treating penetrating injury to extremity?

A

Check for vascular injury

125
Q

Treatment if no vascular injury in penetrating trauma to extremity?

A

Clean wound, tetanus vaccine

126
Q

Treatment if obvious extremity vascular injury?

A

Surgery

127
Q

Treatment if vascular injury to extremity possible?

A

Doppler or CT angio

128
Q

Order of treatment if extremity bone, artery, nerve all injured?

A

Stabilize bone first, then repair artery, leave nerve for last. May need fasciotomy to prevent compartment syndrome.

129
Q

How to treat high velocity GSW (hunting rifle, etc.)?

A

Debride or amputate

130
Q

How to treat extremity crush injury?

A

Fluids, diuretics, alkalinize urine to prevent renal failure from myoglobinemia.

131
Q

How to treat chronic subdural hematoma vs acute?

A

Acute is to elevate head of bed. Chronic is to do a craniotomy!

Surgery Clerkship (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions