Assessed first in trauma patient Correct ans - Airway (*)Degree of burn that is characterized by bone involvement Correct ans - Fourth Complications of head trauma Correct ans - Intracerebral hematoma Extradural hematoma Brain abscess Most common cause of laryngotracheal stenosis Correct ans - Trauma Intervention that can help prevent development of acute renal failure Correct ans - Infusion of normal saline A 26-year-old male is resuscitated with blood transfusion after a motor vehicle collision that was complicated by a fractured pelvis. A few hours later, the patient becomes febrile, hypotensive with a normal CVP, and oliguric. Upon examination, the patient is found to be bleeding from the NG tube and IV sites. Which of the following is the most likely diagnosis? A. Hemorrhagic shock B. Acute adrenal insufficiency C. Fat embolism syndrome D. Transfusion reaction Correct ans - D. Transfusion reaction Skin antiseptic Correct ans - -Ethanol 70% is an effective skin antiseptic -Acetic acid can be used to treat Gram- skin infections -Salicylic acid is used to treat certain skin yeast infections Class IV hemorrhage indicates what % blood loss Correct ans - 55% How does shivering affect body temperature Correct ans - Increases body temperature Class III hemorrhage indicates what % of blood loss Correct ans - 35% Management of a stable patient with kidney contusion Correct ans - Observation Associated with hypovolemic shock Correct ans - -Inadequate tissue perfusion with resultant tissue hypoxia -Blood shunting to vital organs -Decreased circulating blood volume and decreased venous return -Low cardiac output -Loss of less than 20% of the blood volume is usually without symptom except for mild tachycardia -Patients become orthostatic with losses between 20 and 40% -Shock is evidenced by tachycardia, hypotension, oliguria, flat neck veins The most effective method of monitoring the success of resuscitation during CPR? Correct ans - Reactivity of pupils to light Used to ensure correct placement of endotracheal tube Correct ans - -Ultrasound -Bilateral breath sounds -Sustained end-tidal CO2 Total body surface area involved in a burn in an adult to the anterior chest and abdomen Correct ans - 18% What is often caused by carotid massage? Correct ans - Bradycardia Step in a patient diagnosed with tension pneumothorax Correct ans - 1. Needle decompression/ thoracotomy 2. Chest tube True statements regarding diaphragmatic injuries Correct ans - -Blunt diaphragmatic injuries are usually associated with skeletal trauma -Penetrating diaphragmatic injuries may be missed -Repair of traumatic diaphragmatic injuries usually does not require prosthetic material First priority in the treatment of an unconscious patient Correct ans - Checking the pulse A patient involved in a road accident is brought to the emergency department in an unconscious state. On arrival, her vitals show a temperature of 96.4 degrees Fahrenheit, a respiration rate of 24 breaths per minute, a heart rate of 140 beats per minute, and a blood pressure of 80/40 mm Hg. She is cold, shivering, and perspiring profusely. She has bilateral reactive pupils but she does not respond to pain. On physical examination, she has no obvious sign of external bleeding. Which of the following cannot be the cause of hypotension in this patient? A. Pelvic fracture B. Fracture of femur C. Intracranial hemorrhage D. Hemothorax Correct ans - C. Intracranial hemorrhage A patient suffered a slash to his right neck. The wound is over the midportion of the sternocleidomastoid. There is a large hematoma and brisk bleeding when uncovered. He is stable. What is the next step in management? A. Get an angiogram B. Close the wound in the ER C. Take him to the operating room D. CT scan to evaluate neck structure Correct ans - C. Take him to the OR After abdominal injury, which of the following urinalysis findings would be an indication for further testing? A. 0-5 casts/HPF B. 5-10 WBC/HPF C. 10-20 RBC/HPF D. Gross hematuria Correct ans - D. Gross hematuria A laceration of the neck superficial to the deep cervical fascia along the sternocleidomastoid muscle at its midpoint would cause bleeding from which structure? Correct ans - External jugular vein Clinical features associated with tension pneumothorax Correct ans - Unilateral decrease in breath sounds Hyperresonance Respiratory distress Tachycardia Tracheal shift Desatruation Decreased breath sounds Decreased compliance Asymmetric chest movement NOT hypertension, audible bronchial sounds Not recommended as a mode of ventilation for a patient with a diaphragmatic hernia A. Bag and mask B. LMA C. Endotracheal intubation D. Jet ventilation Correct ans - A. Bag and mask What is the next step in the assessment of a traumatic patient after airway is established? Correct ans - Breathing Blood group that is considered a universal donor Correct ans - O
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