Truama 🚘 Flashcards
35y.o male brought to ER after road traffic accident , complaining of right side chest pain, he is conscious, alert & oriented. Surgical emphysema in upper chest and neck. Chest X- ray shows Rt sided pneumothorax & pneumomediastinum. What is the diagnosis
A- Tension pneumothorax
B- Open pneumothorax
C- Tracheobronchial injury
D- Hemopneumothorax
C- Tracheobronchial injury 💛✅
22.p.t ader MVA At ER , BIAm blAm Vitally stable O/E ( Left hypochondrium tenderness and ecchymosis) What is the MOST APPROPRIATE TEST:
A- CT
B- FAST
C- DPL
D- Laparotomy
A- CT ✅💛
Note ;
He might had spleen injury
If he is stable : go with ct
If he is unstable : go with or
Male pt with an abdominal stab wound near the umbilicus, pt was stable and on wound exploration omentum was seen,, ct was done and the report literally said (normal) ,,, what will you do for this patient:
A-observe
B-close the wound
C-leave wound open
D-exploratory laparotomy
D-exploratory laparotomy ✅💛
What are the Indication for laparotomy in abd stab inj ?
🟡 indications are :
1. Hemodynamic instability
2. Peritonitis
3. Impalement
4. Evisceration
5. Frank blood from a nasogastric tube or on rectal examination
Male came to ER after car
accident and wasn’t wearing the
seat belt he had ecchymosis on
the sturnum, his heart rate was
230 + his lungs are clear and
heart sound was clear,
diagnosis?
-cardiac tamponade
-MI
-Heart contusion
-Heart contusion ✅💛
Man came with scalp open wound, after 6h assault, what wound management?
A. Debridement &2ry closure
B. Debridment with 1ry closure
C. Debridment with granulation
D. Leave it for granulation! I think wrote like this
Debridment with 1ry closure ✅💛
292.Patient with polytrauma, intubated and admitted to ICU. How to clear C spine?
A. CT
B. MRI C spine
C. Anterior and lateral C spine XR
CT ✅💛
Most accurate oxygen mask approach.
Dr J file
Male came after rta unconscious with multiple injuries and was intubated with endotracheal tube
What is the best way to confirm tube in right place?
A flat abdomen
B CO monitoring
C movement of chest
D length of tube
CO monitoring ✅💛
Q: Patient present to ER after RTA, with SOB, in examination the tracheal shifted to the right side, in chest X-ray, the lungs are expanded and winded mediastinum. What is the diagnosis.
A:
1. Tension pneumothorax
2. Cardiac tamponade
3. Plural effusion
4. Raptured esophageal
Raptured esophageal ✅💛
Q: Victim of RTA came with pelvic fracture and there’s blood in the meatus, next
step?
A:
1. Folley catheter
2. retrograde urethrogram
3. Pelvic CT
retrograde urethrogram ✅💛
Q: pt after rta with sever back pain , what to do until the surgeon come:
A:
1. A-Ct whole spine
2. B-Flextion extension test
3. C-Make sure the spine doesn’t move
Make sure the spine doesn’t move ✅💛
Q: Stylomastoid injury affect the nerve, what is possible symptom?
A:
1. Anterior 2/3 Taste loss
2. Loss of sensation
Anterior 2/3 Taste loss ✅💛
Note :
Facial nerve is passing through the Stylomastoid foramn.
Patient presented C/O upper abdomen stab below costal margin, No details
about how deep the penetration was, investigation?
A) CT
B) US
C) MRI
CT ✅💛
Highest diagnostic value for inhalation injuries?
A-Tachypnea
B-Voice hoarseness
C-Low O2 sat
D-Carbonaceous sputum
Carbonaceous sputum ✅💛
30 Y/o Mechanic accidentally inject his left index finger with high pressure dissolve
Next:
1. A- oral antibiotic
2. B- oral antibiotics and steroid
3. C- surgical open and drainage
4. D- observation
surgical open and drainage ✅💛
A 35 year old car driver crashed into a concrete block without a safety belt on. Thirty minutes after and on the way by ambulance to the hospital he begins to become breathless. On administration of 100% oxygen there is not much improvement in this condition. On arrival at the Emergency Department he has lost consciousness (GCS 8) and appears cyanosed with markedly distended jugular veins. Blood pressure 80/40
Heart rate 120 /min
Respiratory rate 34 /min
Temperature 36.6 c
Oxygen saturation 60% on room air
What immediate action should be taken?
A. Intubation and 100% oxygen
B. Rapid infusion of crystalloid
C. Needle decompression
D. IV 0.2 mg adrenaline
Needle decompression ✅💛
Note :
He is tension pneumothorax we should treat to correct his situation
Intubation is next
Intubation is indicated for respiratory distress pt except in case of tension pneumothorax
Post RTA, he is shouting and he has blood pressure 90 and he says he has extreme chest pain what to do next ?
1- etablish an iv line
2- do fast
3- pericardiocentsis
etablish an iv line ✅💛
Better recall
RTA, raised JVP and absent breath sounds in the right.
vitales: hypotension, tachycardia, hypoxia
Most likely diagnosis?
A-Right hemothorax
B-Right tension pneumothorax
Right tension pneumothorax ✅💛
Traumatic patient presented to ER with Profuse bleeding from nose and mouth, cyanosed with decreased
breath sound on right side of the chest. Mostly was unstable Which of the following is the most appropriate next step.
A. Right chest thoracostomy
B. Intubation
C. IV fluid resuscitation and O type blood transfusion.
Right chest thoracostomy 💛✅
18 years male came with STAB wound injury next to umbilicus with small opening clean and bleeding stopped, vitally stable with normal lab results, CT scan report showed: small splenic laceration with minimum fluid surrounding it, what is the best definitive management?
A. Wound closure
B. Antibiotics
C. Splenectomy
D. Exploratory laparotomy
Wound closure ✅💛
This is minimal spleen inj :
Would be treated with conservative Mx
Patient had liver laceration and the patient is hemodynamically unstable. What to do?
A. Right hepatectomy
B. Perihepatic packing
C. Right hepatic artery ligation
D. Ligation of the involved vessel
Perihepatic packing ✅💛
Child presents after trauma. CT scan shows minimal abdominal fluid collection and grade 3 splenic
injury, patient stable, what is the management?
A. Two units of PRBCs
B. Non-operative
C. Splenectomy
D. Splenic preservation survey
Non-operative 💛✅
Note :
For the hemodynamically stable patients (Grade 1-3) we suggest non-operative management
Patient who had had multiple traumas in MVA , investigation showed free fluid in the abdomen and spleen laceration + thoracic aortic rupture. Patient was Unstable. Next management?
A. Thoracotomy
B. Laparotomy
C. Ct scan
Laparotomy ✅💛
Note :
Abdomen is 1st
patient with RTA is stable and conscious with a patent airway. His blood pressure is 105/90 mmHg. His GCS score is 15. What is the most appropriate next step?
A. IV Fluid
B. FAST
IV fluid ✅💛 if no O2 related
ABC
-Trauma to the chest
Normal equal air entry lung
Distended JVP
Hypotensive
O2 sat 85%
A. Lung contusion
B. Flail
C. Pneumothorax
D. Temponade
Temponade 💛✅
A patient presents with a knife injury to the hand. On examination, the laceration reached the tendon and nerve. How will you repair this injury?
A Primary repair to injury structures
B Debridement with primary closure
C Debridement with secondary intention
D Debridement with Vacuum assisted closure (VAC
Primary repair to injury structures ✅💛
3- Young male had an accident in a farm with open wound
wound was dirty, and there gas under tissue tissue + skin become dark what is the causative organism?
A-staphylococcus Aureus
B- Clostridium perfringens
Clostridium perfringens ✅💛
Pt have RTA and lose of 25% of blood what is change
A- GS
B-respiratory rate
C-BP
Don’t remember other choices
The Answer is RR 💛✅
Note :
This is Type 2 hemorrhage
Patient with stab wound in anterior neck, he is Alert but in labs oxygen sat 82%. What to do?
A. Oxygen mask
B. Cricothyroidotomy
C. Endotracheal intubation
D. Tracheostomy
?
A mechanic had an accidental injection of oil dissolving in his index finger Finger is red and swollen with mild tenderness and normal joint movement, sensation is intact what to give:
- Oral antibiotic
- Oral Abx and steroids
- Surgical management
- Elevate the hand and ice packing
Surgical management 💛✅
Note :
Need to be evacuated and any debridement to be removed
MVA stable positive FAST?
A. CT
B. Laprotomy
CT ✅💛
