Trauma

Question 1

Acidic vs alkaline caustic ingestion differences

Answer 1

Acidic - coagulative necrosis

Alkaline - liquefactive necrosis

Question 2

Caustic ingestion treatment

Answer 2

Airway protection

Endoscopy within first 24hrs once patient is stabilized

Question 3

which type of open fractures require only gram positive antibiotic coverage?

Answer 3

type I and type II
type I - clean lacs < 1 cm
type II - lacs > 1 cm in length that are not associated with extensive soft tissue damage, flaps, or avulsions

antibiotics can be dc’d 24hr after wound closure

Question 4

which type of open fractures require both gram positive and negative antibiotic coverage?

Answer 4

type III fractures - exposed bones or missing soft tissue, mangled extremities, or requiring vascular repair to the limb

antibiotics for 72 hrs after wound closure

Question 5

grade I blunt aortic injury

Answer 5

intimal tear < 10 mm
tx: BP control (beta blocker), anti-platelet
eventually, repeat imaging until resolution is documented

Question 6

grade II blunt aortic injury

Answer 6

intimal flap > 10 mm

tx: BP control, anti-platelet, repeat imaging within 7 days to assess for progression

Question 7

grade III blunt aortic injury

Answer 7

pseudoaneurysm

Question 8

grade IV blunt aortic injury

Answer 8

evidence of rupture with either contrast extravasation on imaging or hemothorax on exploration

Question 9

best option for repair of blunt popliteal artery injury

Answer 9

contralateral GSV