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Summer 2020 - APA Foundations 2 - Other > Trauma & Anesthesia - Quiz 7 > Flashcards

Trauma & Anesthesia - Quiz 7 Flashcards

1
Q

What are the 3 areas w/ the Highest incidences of Recall?

A

CV

OB

Trauma

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2
Q

What are factors that can potentially indicate Cervical Spine Injury?

A

Neck Pain

Severe Distracting Pain

Neuro Signs & Symptoms

Intoxication

Unconscious @ the Scene

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3
Q

What is the best way to Intubate a patient w/ a Cervical Spine Injury?

A

Manual Inline Stabilization (MILS) using a Glidescope

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4
Q

Why should N2O be avoided in Trauma Patients?

A

Expands Closed Spaces

Trauma patients might have Pneumothorax, Pneumocephalus, or Pneumoperitonium

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5
Q

What can happen if Sux is given to patients who sufferred from a Burn, Spinal Cord, or Crush Injury in the past 24 hrs?

A

Hyperkalemia

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6
Q

How do Massive Blood Transfusions affect Systemic pH?

A

Metabolic Alkalosis

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7
Q

What are the potential Cardiovascular Effects of receiving > 1 unit PRBC per 5 minutes?

A

Cardiac Depression d/t Hypocalcemia

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8
Q

What are the signs & symptoms of a Hemolytic Reaction in an Anesthetized patient?

A

↑Temp

Tachycardia

Hypotension

Hemoglobinuria

Oozing

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9
Q

What are the Hematologic effects of Hypothermia?

A

Coagulopathy

Platelet Sequestration

Deformed RBCs

Myocardial Malfunction

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10
Q

What is the main cause of Bleeding after a Massive Transfusion?

A

Dilutional Thrombocytopenia

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11
Q

What is the Half-Life of Crystalloids?

A

20 - 30 minutes

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12
Q

What is the Half-Life of Colloids?

A

3 - 6 Hours

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13
Q

Which Crystalloid is more likely to cause Hyperkalemic Acidosis?

A

Normal Saline > LR

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14
Q

Why should LR never be hung w/ Blood?

A

The Calcium in LR is less compatible w/ Blood Transfusions

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15
Q

Which fluids are contraindicated in Trauma patients?

A

Fluids containing Dextrose - can worsen Ischemic Brain Damage

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16
Q

What is the affect of Lactated Ringers on Cerebral Edema?

A

LR’s Hypotonicity + Large Volume = Worsens Cerebral Edema

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17
Q

What are the different Colloids used to rapidly restore Intravascular Volume?

A

Albumin

Dextran - causes coagulopathy

Hetastarch - causes coagulopathy

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18
Q

Which Blood Type can be given w/o a prior Type & Screen in Emergency Situations?

A

O Negative

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19
Q

With Stored Blood, what happens to Factor VIII after two days of storage?

A

Reduced Factor VIII by 50%

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20
Q

Hypovolemia patients require ______ anesthetics d/t a Decrease in Cardiac Output & Increased Ventilation

A

Hypovolemia patients require LESS anesthetics d/t a Decrease in Cardiac Output & Increased Ventilation

21
Q

What are the preferred Induction agents for a Hypovolemic Trauma Patient?

A

Ketamine & Etomidate

22
Q

What might the sign of Hematuria indicate in the Trauma Patient?

A

Kidney or Lower Urinary Tract Injury

23
Q

What are patients w/ Cervical Spine Injuries at risk for?

A

Aspiration

&

Circulatory Failure –> Poor Organ Perfusion –> SHOCK

24
Q

What are signs of a Brain Injury in the Trauma Patient?

A

AMS

Low GCS

Restlessness

Convulsions

Cranial Nerve Dysfunction

Non-Reactive Pupils

25
What is Cushing's Triad?
HTN Bradycardia Irregular Respirations **These are LATE signs** **before Herniation**
26
What medications induce Pupillary Dilation?
Anticholinergics: Robinul Spiriva Atrovent
27
What meds should be avoided if a patient is to have a Neuro Exam?
Avoid Sedatives & Analgesics
28
What are the symptoms commonly associated w/ Cardiac Tamponade?
**Beck's Triad** Jugular Distension Hypotension Muffled Heart Sounds
29
What is Pulsus Paradoxus?
A 10 mmHg drop in BP during Spont. Ventilation
30
Why should Propofol be avoided in pts w/ Cardiac Tamponade?
Can severely drop BP and lead to death
31
What should be monitored very closesly during a Pericardialcentesis?
EKG for ectopy
32
How do Massive Transfusions affect the Potassium Level?
Hyperkalemia
33
What is a concern associated w/ Pelvic and Long Bone Fractures?
Fat Embolism Hypovolemia Blood Loss
34
What are the signs indicating a Fat Embolism?
↑Lipase Fat in Urine Thrombocytopenia
35
What is the main goal for the pt undergoing Extremity Reattachment?
Normothermia Avoid shivering to help Reperfusion
36
Which Lefort Fracture is this?
Lefort 2
37
Which Lefort Fracture is this?
Lefort 3 Fracture of Skull Base thru the Eye Sockets Increased risk of Intubating into the Brain
38
Which Lefort fracture is this?
Lefort 1
39
How can Intracranial Hypertension be controlled?
Fluid Restriction Diuretics - Mannitol Hypocapnia (PaCO2 26 - 30 mmHg)
40
What can help save Brain Tissue in a Head Injury?
*Mild* Hypothermia
41
Injury to which Spinal Cord segments cause Apnea?
C3-C5 "3,4,5 keeps you alive"
42
A High Spinal Cord Injury can cause Spinal Shock & Loss of Sympathetic Tone. What are the symptoms?
Hypotension Bradycardia Warm Touch Areflexia GI Atony
43
What are the symptoms of Autonomic Hyperreflexia?
HTN HR Changes Skin Color Changes Diaphoresis
44
What is a Simple Pneumothorax?
Air in Parietal & Visceral Pleural causing Lung Collapse & V/Q Mismatch Positve Pressure can convert Simple to Tension PTX
45
What is a Tension Pneumothorax?
Air _trapped_ in Pleural Space & increases w/ Insipration causing Tracheal Shift
46
How is a Simple Pneumothorax treated?
Chest Tube @ 4th or 5th ICS
47
How is a Tension Pneumothorax treated?
14 ga. Needle @ 2nd ICS & Midclavicular, then Chest Tube
48
What should be done for a Hemothorax?
Isolate Bleeding Lung from Healthy Lung w/ Double Lumen Tube
49
What are the causes of the Delayed Lung Reponse known as ARDS?
Sepsis Trauma Aspiration Head Injury Fat Emboli Massive Transfusion

Summer 2020 - APA Foundations 2 - Other (10 decks)

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