Trauma / Surgery Flashcards
When should preoperative creatinine levels be checked?
patients >40yrs old
Best determinant of bleeding tendencies during surgery?
coagulation response to minor trauma
In what patients are silent MIs seen more commonly?
Elderly and diabetics
When is a pregnancy test indicated for preoperative evaluation of a patient?
All women of childbearing age
What are classic factors associated with higher risk of DVT?
Virchow’s Triad:
- stasis
- intimal damage
- hypercoagulability
What is the preferred DVT prophylaxis for trauma patients, or those with abdominal or pelvic cancer?
Lovenox (enoxaparin)
True / False: enoxaparin dose needs to be adjusted for renal impairment
True
What should always be ruled out with evaluation of diarrhea and enteral feedings?
C Diff
Leading cause of death between 1-44 years old?
unintentional and violence-related injuries
Leading cause of accidental death in the US?
motor vehicle accidents
Signs of cardiac tamponade?
Beck’s Triad:
- JVD
- Hypotension
- muffled heart sounds
How are most cases of penetrating chest trauma managed?
tube thoracotomy
Test of choice for detecting intra-abdominal injury?
FAST exam (Focused Assessment with Sonography for Trauma)
True / False: the presence of a pulse distal to site of vascular injury rules out significant vascular injury?
False
Evaluating a head trauma patient, you notice rhinorrhea, otorrhea, ecchymosis of lids (raccoon eyes) and ecchymosis behind ears (Battle’s sign) - what do you suspect?
basilar skull fracture
Injury to what artery is the usual cause of epidural hematomas?
middle meningeal artery
What is common mental status presentation of a patient with epidural hematoma?
Brief period of unconsciousness, followed by a lucid interval
Tried of signs indicative of brain herniation?
Coma
Fixed / dilated pupils
decerebrate posturing
Most common type of burn?
scald burns
How are first degree burns characterized?
erythema, tenderness and NO blisters
A burn victim presents with thin-walled, fluid-filled blisters that are moist, blanch with pressure and are painful - what do you suspect?
second degree burn
Characteristic appearance of third degree burn?
dry, with white / leathery or charred appearance, withOUT sensation
When estimating body surface percentage for burns, what percentage does the patient’s palm represent?
1%
Most commonly used topical burn ointment?
sulfadiazine (silvadene)
Most common complication associated with all burns?
infection
Most likely cause of post-op fever, 24-48 hrs post-op?
Atelectasis (Wind)
Most likely cause of post-op fever, 48-72 hrs post-op?
UTI (Water)
Most likely cause of post-op fever, >72 hrs post-op? Which pathogen responsible?
Wounds, Staph Aureus
Most common nosocomial acquired infection?
UTIs
Most effective approach to preventing pressure ulcers?
Frequent position changes, removal of moisture
What patients is necrotizing fasciitis more common?
DM
Alcoholics
IV drug abusers
Most important complication of lap chole?
biliary injury
Most common complication of surgically repairing an inguinal hernia?
recurrence of that hernia
Most common complication of open appendectomy?
wound infection
Most common complication of lap appendectomy?
intra-abdominal abscess
Most important preop evaluation by a surgical team?
H&P
Common post-op complication with unfractionated heparin?
hematoma
Most common indication for intubation in a trauma patient (in context of primary survey)?
altered mental status
