TRAUMA

Question 1

BLUNT carotid injury managent

Answer 1

(grades 1-5)

antigoag Grade 1 through 3+
Recheck CTA in seven days and discontinue anticoagulation

grade 3 pseudoaneurysm - embolized and anticoagulate

Grade 5 is a transaction need to go to the operating room

If there is a hint of flow fix-it

If there is no flow leave it alone

(Osler case)

Question 2

With special management doesn’t triple negative breast cancer need

Answer 2

Add Taxol

Question 3

Management of locally advanced disease

Answer 3

Chest wall

XRT

Also use XRT to the axilla if four or more nodes

Question 4

When do use neoadjuvant therapy

Answer 4

Triple negative
Her2-nu +
Locally advanced
Inflammatory breast cancer

Question 5

tripple tube

Answer 5

cystic duct drainage

lateral duodonostomy tube

feeding J

Step 1: kocherization of the duodenum.
Step 2: repair of the perforation - omentum overlay
Step 3: cholecystectomy and insertion of the C-tube (6 Fr) into the common bile duct via the cystic duct.
Step 4: creation of a retrograde tube duodenostomy.
Step 5: creation of a feeding jejunostomy.

Question 6

Suture used to repair the diaphragm

Answer 6

0 Pledget proline

If large defect consider proceed mesh with biologic Side towards the bowel

Question 7

Initial chest tube output that mandates going to the operating room

Answer 7

1500 mL

150 – 200 mL per our times four hours

Question 8

What is proceed mesh made out of

Answer 8

soft polypropylene

oxidized regenerated cellulose

Question 9

Tradename mesh polypropylene

Answer 9

Marlex

Prolene

Question 10

Generic name mesh vicryl mesh

Answer 10

polyglactin 910)

Question 11

Best x-ray view to evaluate urethral injury on retrograde urethrogram

Answer 11

Lateral

Question 12

Treatment of urethral injury

Answer 12

Do not primary repair

Super pubic catheter

Repair stage

Question 13

Head injury management

Answer 13

Had a bad 30°

Mannitol 0.5-1 g / kg

Osm goal of 10.30- 10.40

can start with 7% saline x 30 mL!

then 3%

Sodium 155

Barbiturate coma

Paralyze

Ventriculostomy

Question 14

Sensory of deltoid

Answer 14

The axillary nerve

Question 15

What is the ratio of heparin in the heparin flush

Answer 15

1,000 units in 10 mL NS

Question 16

Vaughn pyloric exclusion

Answer 16

repair / patch duo

pyloric exclusion

Gastro J

Question 17

Intraoperative cholangiopancreatography during trauma exploration

Answer 17

performed through an existing duodenal wound,
or
via anterior duodenotomy.

A catheter is directed into the common bile duct or pancreatic duct

injecting 2 to 5 mL of soluble contrast into the duct while imaging using fluoroscopy or shooting a plain film.

Intraoperative endoscopic retrograde cholangiopancreatography (ERCP) can also provide the necessary imaging but would require the abdomen to be closed and the patient to be re-positioned in lateral decubitus position on a radiolucent table.