TrmaPP Flashcards
How do you preserve an amputated organ in the field?
- Sterile physiological solution
- In sterile gauze and put in a waterproof plastic bag which is placed in an other plastic bag containing ice water
- In betadine solution or any other disinfectant
- In the patient’s pocket
- None of the above
- In sterile gauze and put in a waterproof plastic bag which is placed in an other plastic bag containing ice water
Autulogous osteohondral mosaic plasty is awidely used treatment option for cartilage repair. What is an optimal indication?
- Elderly patient, over the age of 50, osteoarthritic changes of the knee
- Extended grade II chondropathy of the patella
- Symptomatic focal (1-4 square centimeter in size) chondral or osteochondral defects of the weight bearing articular surfaces
- Extended grade I chondropathy of the non-weight-bearing articular surfaces of the knee
- “Kissing chondropathy” of the femoropatellar joint
- Symptomatic focal (1-4 square centimeter in size) chondral or osteochondral defects of the weight bearing articular surfaces
Which graft type is recommended for ACL reconstruction? (MCQ)
- Hamstring tendons
- Synthetic ACL graft
- Bone-tendon-bone graft
- Plantaris tendon
1 and 3
Which laboratory results have diagnostic values for infections? (MCQ)
- CRP
- WBC
- PCT
- ESR
All
hich of the following is/are life threatening chest injuries? (MCQ)
- Traumatic aortic injury
- Massive hemothorax
- Tension PTX
- Flail chest
All
Which of the following is/are typical for concussion (commotio cerebri) (MCQ)
- Blow to the head
- Transient loss of consciousness
- Complete recovery
- Incomplete recovery
1, 2 and 3
- Blow to the head
- Transient loss of consciousness
- Complete recovery
NO neurological focal signs are seen in
- Concussion
- Contusion
- Epidural hematoma
- Subdural hematoma
- Intracerebral bleeding
- Concussion
Concussion - LOC and negative CT
Case with dull thoracic injury: the patient is battling for breath, has dilated cervical veins. What do you think? (MCQ)
- Injury to the aorta
- Tension PTX
- Tracheal injury
- Pericardial tamponade
2 and 4
- Tension PTX
- Pericardial tamponade
Which are true concerning the Pipkin classification of femoral head fractures (MCQ)
- Type I: fracture inferior to fovea centralis
- Type II: fracture superior to fovea centralis
- Type III: type 1+2 and femoral neck fracture
- Type IV: type 1+2 and intertrochanteric fracture
1, 2 and 3
When should femoral neck fractures be treated with arthroplasty? (MCQ)
- Garden type IV fracture, subcapital fracture
- Garden type II fracture, when the time between injury and surgery is less than 5 hours
- Impossible reduction
- Garden type I fracture
1 and 3
Which muscle is NOT a part of the rotator cuff?
- Supraspinatus
- Infraspinatus
- Subscapularis
- Teres minor
- Teres major
- Teres major
Which of the following belong to extensor system injuries of the knee? (MCQ)
- Quadriceps rupture
- Unhappy triad (medial meniscus rupture, ACL and LCL)
- Patellar ligament rupture
- PCL rupture
1 and 3
Possible reasons for pneumothorax (MCQ)
- Rib fracture
- Diaphragm rupture
- Lung injuries
- Oesophagus injuries
1 and 3
All?
An elderly woman is brought into the ER after she fell and a hip fracture is suspected. She cannot bear weight on the affected side. There is no visible fracture on the x-ray. What to do? (MCQ)
- Painkillers are given, no further treatment is needed
- MRI because occult primary fractures often does not show up on x-ray
- Send her to rehabilitation, no further treatment is needed
- Do a follow up x-ray in 10 days, meanwhile give her pain med and try to mobilize the patient
4
- Do a follow up x-ray in 10 days, meanwhile give her pain med and try to mobilize the patient
What is forbidden to do with a bite wound?
- Clean up the wound
- Excise the wound
- Give antibiotics
- Suture the wound
- Use plaster
- Suture the wound
which of the following are clinical symptoms of femoral neck fractures? (MCQ)
- Abduction
- Internal rotation
- Shortening
- Ability of active lower extremity elevation
1 and 3
Which statement(s) is/are true about pediatric trauma? (MCQ)
- Not different than adult fracture care
- After conservative treatment, children experience more severe stiffness of joints
- There are more surgical indications than in adults
- After epiphyseal separations, the child needs to be monitored long enough to diagnose a possible growth arrest
4
- After epiphyseal separations, the child needs to be monitored long enough to diagnose a possible growth arrest
Humoral fracture, what conditions are taken into consideration? (MCQ- no answers)
Possible options:
- Age
- General condition (osteoporosis)
- Neer classification
Indications of revision hip arthroplasty (MCQ)
- Cup, stem malposition
- Dislocation, instability
- Aseptic – septic loosening
- Pertrochanterical fracture
1, 2 and 3
Which type of x-ray should be done in the case of a pelvic fracture? (MCQ)
- AP view
- Ala view
- Obturator view
- 30 internal rotation view
1, 2 and 3
What might be the treatment of closed transversal tibial and fibular diaphysis fractures in adults? (MCQ)
- Reduction and plaster immobilization for 8-12 weeks
- Cerclage
- Intramedullary nails
- Extension for 3 weeks and then cast for 8-10 weeks
1 and 3
Functional hand position: (MCQ)
- The MP joints are bent in 60-90 degrees
- The wrist is in 90 degree flection
- The PIP joints are bent in 20-30 degree flexion
- The wrist is in 30 degree ulnar duction
1 and 3
- The MP joints are bent in 60-90 degrees
- The PIP joints are bent in 20-30 degree flexion
A patient falls with an extended wrist. The patient complains of pain to pressure on the dorsal side of the wrist, distal to the radius. AP and lateral radiographs shows no signs of fracture. Which can be a next possible step in diagnosis/treatment? (MCQ)
- 10-14 days Bennet splint, then follow-up x-ray
- 4 directional wrist x-ray
- Wrist CT scan
- Wrist arthrography
1, 2 and 3
Intraosseous infusion into the bone marrow (MCQ)
- Is appropriate for the urgent administration of medicine and liquids when venous access is not possible
- Is the recommended way for blood transfusion in infants
- Is usually accessed through the tibia
- Is a routine daily method for venous access in adults
1 and 3
- Is appropriate for the urgent administration of medicine and liquids when venous access is not possible
- Is usually accessed through the tibia
Which vasopressors + volume expanders are used to treat hemorrhagic shock?
- None
- Isoproterenol
- Adrenaline
- Voluven (HES - Colloid solution)
- Voluven (HES - Colloid solution)
The following is true for reamed intramedullary nailing (MCQ)
1. There is a risk of fat embolism
2. Exhaustion fracture of the implant occurs more often than in case of unreamed intramedullary nailing
3. Promotes upsetting at the fracture site and results in greater stability than unreamed nailing due to better
fitting index
4. It is used for fixation of lumbar vertebral fractures
1 and 3
Which of the following is innervated by the median nerve? (MCQ)
- M. Abductor pollicis
- M. Flexor pollicis
- M. Flexor digitorum profundus
- M. Opponens pollicis
All
When should non-union be considered? (MCQ- no answers)
- Bone healing over 6 months
2. Absolute operative indication
Which of the following is/are true concerning shock? (MCQ)
- Inadequate tissue perfusion and oxygenation
- Does not result from isolated brain injury
- Hemorrhage is the most common cause
- Vasopressors are contraindicated
1 and 3
Which implant in which situation should be used for femoral shaft fractures? (MCQ)
- Monotrauma: undreamed nailing with interlocking
- Intraarticular fracture: plate fixation
- Polytrauma: reamed nailing with locking
- Compartment syndrome: plate fixation
2 and 4
Where is “no mans land”?
- At the fingertips
- In the palm
- At the dorsal surface of the hand
- Along the hand’s flexor tendon sheaths
- At the volar surface of the wrist
- Along the hand’s flexor tendon sheaths
Which treatments is/are recommended for a simple rib fracture? (MCQ)
- Antibiotics
- Physiotherapy
- Fixation with adhesive plasters
- NSAIDs and expectorants
- NSAIDs and expectorants
What belongs to the rotator cuff? (MCQ)
- Supraspinatus tendon
- Biceps long head tendon
- Subscapularis tendon
- Quadriceps tendon
1 and 3
Which is the first phase of the bone healing process?
- Remodeling phase
- Reparative phase
- Inflammatory phase
- Catabolic phase None of the above
- Inflammatory phase
The following statements apply for femur diaphysis fractures: (MCQ)
- Since the injury is intracapsular, the blood loss is minimal
- Best treatment is intramedullary nailing
- Conservative treatment is recommended
- External fixation is an option in case of polytraumatized patients (ARDS etc)
2 and 4
- Best treatment is intramedullary nailing
- External fixation is an option in case of polytraumatized patients (ARDS etc)
Which of the following does not belong to the secondary survey of a severely injured patient?
- Allergies
- Medications
- Last menstruation
- Past illnesses
- Events/environment
- Last menstruation
What is the therapy of upper thoracic vertebral fractures with no neurological symptoms, and less than 50% vertebral compressions?
- Pain relief, early mobilization
- Surgery
- Crutchfield extension
- Decompression
- Immobilization by plaster
- Pain relief, early mobilization
The following statement(s) is/are true about plaster application (MCQ)
1. Circular plaster should be applied in case of fresh trauma and postoperatively
2. After applying a cast on a fresh trauma patient, observation is necessary, especially for the symptoms of
compartment syndrome, pain, capillary filling, sensation, range of motion
3. Use hot water, so that the cast can be remodeled for a longer time
4. Thrombosis prophylaxis is necessary in lower extremity casts
2 and 4
- After applying a cast on a fresh trauma patient, observation is necessary, especially for the symptoms of
compartment syndrome, pain, capillary filling, sensation, range of motion - Thrombosis prophylaxis is necessary in lower extremity casts
The following statements are true about pertrochanteric fractures (MCQ)
- Intracapsular fracture
- Symptoms are that the affected limb is shortened, is in external rotation, the patient cannot actively raise it
- Avascular necrosis is a common sequelae
- Primary stabilization can be done with skin or skeletal extension
2 and 4
- Symptoms are that the affected limb is shortened, is in external rotation, the patient cannot actively raise it
- Primary stabilization can be done with skin or skeletal extension
Which of the following belong to the primary survey of a severely injured patient? (MCQ)
- Removal of foreign body obstructing the airway
- Percussion of the thorax
- Assessment of pulse
- Obtaining C-spine, chest and pelvic radiographs
All
What kind of diagnostic procedure is appropriate to localize an intracranial bleed? (MCQ)
- CSF exam
- Glasgow coma scale
- Fundus examination
- CT
- CT
What is the name of the partial fracture of the periosteum in childhood resulting only in bending?
- Pathological fracture
- Stress fracture
- Pseudoarticulation
- Greenstick fracture
- Prefracture state
- Greenstick fracture
Weber type classification of ankle fractures are graded as to how the level of the fibular fracture relates to the the syndesmosis (1), therefore type A fractures are supination injuries and type B and C fractures are pronation injuries (2)
a. 1 and 2 are correct and related
b. 1 and 2 are correct but not related
c. 1 is true, 2 is false
d. 1 is false, 2 is true
e. 1 and 2 are both false
b. 1 and 2 are correct but not related
The best way to distinguish a scaphoid fracture?
- Clinical signs
- Clinical signs and 2-way x-ray
- 4-view x-ray
- Tomography
- Functional examination under x-ray
- 4-view x-ray
Which of the following are supination (eversion) injuries of the ankle and foot? (MCQ)
- Weber A fracture
- Talofibular ligament rupture/sprain
- Chopart joint distortion
- V. metatarsal base avulsion fracture
All
What is true for direct healing?
- Heals faster than indirect
- Looks the same as before the injury
- Callus formation
- Requires periosteal blood flow
1 and 4
- Heals faster than indirect
- Requires periosteal blood flow
Which infection has the best prognosis?
- Intraarticular
- Epifascial
- Tendovaginal
- Body-cavity
- Peri-implant
- Epifascial
The following can be determined by the Glasgow coma scale (MCQ)
- Motor response
- Verbal response
- Eye opening
- Pupillary response
1, 2 and 3