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Science to Clinical Practice 2 > Trauma and Accidents > Flashcards

Trauma and Accidents Flashcards

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1
Q

What is a closed loop obstruction in the abdomen?

A

Bowel obstructed at 2 separate points

Surgical emergency as bowel distends until it becomes ischaemic/perforates

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2
Q

What symptom is not common in closed loop obstruction?

A

Vomiting

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3
Q

Valvulae conniventes vs haustra

A

Folds in small bowel vs large bowel

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4
Q

What is rebound tenderness?

A

Pain on release of pressure compared to pain on palpation

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5
Q

On palpation of abdomen for obstruction, when would pt have guarding or rebound tenderness?

A

Ischaemia

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6
Q

What are neck of femur fractures typically caused by?

A

Low energy injuries - frail + elderly, falls

High energy injuries - younger, RTC, fall from heights

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7
Q

What is functional bowel construction/paralytic ileus?

A

Bowel X mechanically blocked but X work properly

e.g. inflam, electrolyte derangement, recent surgery

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8
Q

Why is CT scan preferred over AXR for bowel obstruction?

A

more sensitive for bowel obstruction;
differentiate between mechanical/pseudo obstruction
demonstrate site + cause of obstruction
may demonstrate presence of metastases if caused by a malignancy

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9
Q

What are the difference between a primary and secondary spinal injury?

A

Primary - immediate, unavoidable, spinal cord oft appears normal immediately after trauma (unless penetrating)
Secondary - min + hrs, preventable, progressive neurological deterioration

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10
Q

Examples of primary and secondary spinal injuries

A

Primary - compression, contusion, shear injury

Secondary - ischaemia, hypoxia, inflammation

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11
Q

What are some high risk factors for C-spine assessment?

A

Age > 65
Dangerous mechanism
Paresthesia in extremities

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12
Q

When imaging for spinal injuries, what views should you get?

A

Cervical - AP, lateral, open mouth PEG

Thoraco-lumbar - AP, lateral

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13
Q

What is neurogenic shock?

A

sudden loss of SNS signals

Hypotension, Warm flushed skin, Bradycardia, Hypothermia, Priapism (long-lasting painful erection)

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14
Q

What is spinal shock?

A

immediate temporary loss of total power, sensation reflexes below level of spinal cord injury

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15
Q

Why is hard to assess spinal shock?

A

Can only assess when bulbous cavernosus reflex returns - marks end of spinal shock

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16
Q

Mechanism of neurogenic shock and spinal shock?

A

Neurogenic - disruption of autonomic pathways ==> loss of sympathetic tone + vasodilation
Shock - peripheral neurons temporarily unresponsive to brain stimuli

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17
Q

What type of fractures is the lumbar spine subject to?

A

Axial compression

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18
Q

How to calculate cerebral perfusion pressure

A

Cerebral perfusion pressure = mean arterial pressure + intracranial pressure

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19
Q

What are the 5 signs of a base of skull fracture?

A

Panda eyes, subhyaloid haem, subconjunctival haemorrhage, oto/rhinorrhea, Battle’s sign

20
Q

How do you kill bugs that enter the ear?

A

Mineral oil/lidocaine

21
Q

When are Abx given in cases of tympanic membrane perforation?
Which one should you avoid and why?

A

In evidence of infection

Gentamicin, toxic to inner ear

22
Q

What test should you carry out in pt with tonsilitis?

A

Mono spot - EBV

23
Q

How do you treat tonsillitis when pt presents to hospital?

A

IV paracetamol, dexamethasone, fluids, Abx

24
Q

What is aphonia?

A

Complete upper airway obstruction

25
Q

What is piriformis syndrome?

A

Entrapment of sciatic nerve due to trauma/

Strain of piriformis muscle

26
Q

What symptom is associated with piriformis syndrome?

A

‘Wallet’s sign’ - x sit on a wallet without causing pain

buttock pain and paresthesia in distribution of sciatic nerve

27
Q

How would you treat a dislocated patella?

A

Reduce under N2O

28
Q

What is a bipartite patella?

A

Congenital, failure of patella fusion
2 separate bone fragments, connected by fibrocartilaginous tissue
Asymptomatic

29
Q

How to calculate the number of units in a drink?

A

(Volume of drink (ml) x % ABV) / 1000

30
Q

Do women or men have more gastric dehydrogenase?

A

Men - 50% lower in women

31
Q

Why do some people have alcohol intolerance?

A

Genetically inherited aldehyde dehydrogenase 2 (ALDH2) - less/inactive
X convert acetaldehyde ==> acetic acid

32
Q

Symptoms of alcohol intolerance

A

Flushing of head + neck, warm pink/red chest
Nausea + vomiting
Hypotension
Hangover like symptoms

33
Q

Why is repeated naloxone doses sometimes required in treatment of opioid overdose?

A

Naloxone has shorter half life compared to all opioid analgesics

34
Q

How do you treat carbon monoxide poisoning?

A

Hyperbaric oxygen therapy - breathe in pure O2 in air pressure levels 1.5-3x higher than average

35
Q

Why may a rust ring occur in an eye?

A

Retained metallic foreign body

36
Q

Why should a febrile child with assumed cellulitis of eyelid be admitted to hospital?

A

Cellulitis in middle prt of face (triangle of death) can spread into cranial cavity via venous pathways.

37
Q

How would you treat a chemical ocular injury?

A

Irrigate until normal pH - 6-5-8.5/same as unaffected eye (severe burns need continuous irrigation, 30 min)
Analgesia
Chloramphenicol ointment

38
Q

Where is the most common area for a clavicle fracture?

A

Middle third

39
Q

What is the most common treatment for upper limb injuries above the elbow?

A

Sling

40
Q

What is the most common type of shoulder dislocation?

A

Anterior

41
Q

Which peripheral nerves are most at risk from an anterior shoulder dislocation?

A

Axillary and suprascapular nerves

42
Q

What is a Holstein-Lewis fracture?

A

fracture of distal third of humerus

can entrap radial nerve

43
Q

Open vs closed reduction in management of fractures

A

Open - surgically expose fracture fragments

Closed - manip of bone fragments without surgical exposure

44
Q

What chest x-ray positioning/view may make the heart look wider?

A

AP - heart further away from film

Supine - heart falls back due to gravity

45
Q

How to calculate mean arterial pressure?

A

2 x (DBP + SBP) / 3

Science to Clinical Practice 2 (3 decks)

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