Trauma/orthopedics

Front 1

What is the most appropriate diagnostic study in trauma patients with blood at the urethral meatus?

Back 1

retrograde urethrogram

Front 2

In the setting of acute trauma, this test should be performed if the excretory urogram shows renal nonfunction (nonvisualization) or gross renal distortion

Back 2

Selective renal arteriography

Front 3

In trauma patients with signs of intramural duodenal hematoma (gastric outlet obstruction), what is the most sensitive diagnostic study?

Back 3

Upper GI air-contrast study

Front 4

What is the most common injury associated with a shoulder lap-belt?

Back 4

Rib fracture

Front 5

What is the most effective way to decrease acutely elevated intracranial pressure secondary to trauma

Back 5

Intubation and hyperventilation
A ventilatory rate of 20/min with adequate TV (10-12ml/kg) should keep the pCO2 at 22mmHg, which is the goal. Blood gasses should be done as often as necessary. an etCO2 monitor may be used in the field hospital until ABGs are available

Front 6

What is the immediate cause of death from an untreated tension Pneumothorax

Back 6

Relative hypovolemia. The tension severely impedes venous return which results in a fatal reduction in cardiac output

Front 7

In a patient presenting with a hyphema or a periorbital hematoma, what diagnosis should be ruled out ?

Back 7

Orbital fracture

Front 8

Regarding patients with head trauma, what is the chance of epilepsy developing if the patient experiences the first seizure within one week of injury?

Back 8

25%

Front 9

When viewing cervical spine films in a child with possible injury, what are normal findings?

Back 9

Wedging anterior cervical bodies, esp c3, seen up to age 12
ant pseudosubluxation of c2 over c3

Front 10

What is the mechanism whereby infectious tenosynovitis occurs with the flexor tendon of the finger?

Back 10

Penetrating trauma, particularly a puncture wound, along with the volar finger or in the palm of the hand

Front 11

Clinical presentation: A young athlete complains of lower leg pain with no history of trauma. The lower leg is firm and tender lateral to the tibia, but it is equal girth when measured against unaffected side. What diagnosis must be ruled out?

Back 11

Acute compartment syndrome
Remember Pain, paralysis, pallor, pulselessness, paresthesias.
If untreated, ischemia of the nerves and muscles leads to the end stage known as Volkman's Ischemic Contracture

Front 12

What is the leading cause of death in patients sustaining pelvic fractures?

Back 12

Hemorrhagic shock

Front 13

Which nerve injury is most commonly associated with glenohumeral dislocations?

Back 13

Axillary

Front 14

Fractures of the clavical are most likely to occur in which region of the bone?

Back 14

Middle third

Front 15

What is the most common mid foot fracture?

Back 15

Fracture of the base of the second metatarsal with separation of the first and second metatarsals (lisfranc fx)

Front 16

What is the most immediate concern in patients with fractures of the tibia and fibula?

Back 16

Compartment syndrome

Front 17

Calcaneus fx may be associated with what other fracture or injury?

Back 17

Lumbar compression fracture

Front 18

Damage to which nerve is frequently associated with acetabular fx?

Back 18

Sciatic

Front 19

What is the most common dislocation of patella?

Back 19

Lateral

Front 20

The patient with head injury is unresponsive to both verbal and painful stimuli. There is no eye opening whatsoever. What is the Glasgow coma score?

Back 20

3

Front 21

An elderly woman who was rear-ended in a MVA sustains the cervical injury. She complains of neck pain. You find upper extremity weakness that does not localized to any particular spinal level. What is the diagnosis?

Back 21

Central cord syndrome

Front 22

An absent DTR at the ankle suggests a lesion of which nerve root?

Back 22

S1

Front 23

What is the most common type of hip dislocation and what are expected physical findings?

Back 23

Poster dislocation occurs and 90% of cases. The leg is shortened, adducted, internally rotated. The most serious complication is avascular necrosis of the femeral head and is due to delay in reduction.

Front 24

What is the treatment for a paronychia?

Back 24

I&D, PO abx, warm soaks.
S. aureus is usual organism.
If the process extends under the nail, a portion of the nail must be removed

Front 25

regarding DPL in children, 1) how much LR or NS is infused? 2)Why is this important? 3)how accurate is DPL if criteria are strictly followed?

Back 25

1) 15ml/kg
2) To interpret cell counts correctly.
3) 95%

Front 26

Where diaphragmatic perforation is a possibility (low chest Or upper abdominal penetrating trauma), what RBC count is considered positive for the lavage fluid?

Back 26

5000/mm3

Front 27

Clinical presentation: a patient has a facial laceration which requires suturing. He claims an allergy to procaine. Which of the following is the safest choice for local anesthesia?
a) benoxinate HCl
b) benzocaine
c) cocaine
d) tetracaine
e) mepivacaine

Back 27

e) mepivacaine is an amide

Front 28

What is suggested when there is: inability to flex DIP and signs of traumatic tenosynovitis?

Back 28

Rupture of the flexor digitorum profundus tendon

Front 29

Which amputation of the hand have the best prognosis for reimplantation?
How should the amputated parts be preserved?

Back 29

digits/thumb
Using sterile gloves, wrap the parts in a bag, place in iced water in an insulated container

Front 30

pt w hx of knee injury states that he heard a popping sound at the time of injx. on exam, u find hemarthrosis of the joint. What structure is most likely injured?

Back 30

ACL

Front 31

Where are the tendinous insertions of the muscles comprising the rotator cuff?

Back 31

subscapularis inserts on less tubercle of humerus. supraspinatus, infraspinatus, and teres minor insert on greater tubercle.

Front 32

Clinical presentation: The patient complaints of painful shoulder after a fall. There's no fracture. On exam, there's weak and painful abduction with tenderness over the greater tuberosity. What is the diagnosis?

Back 32

Injury of the rotator cuff. Partial tears are more common than complete, and the supraspinatus is the most commonly involved muscle.

Front 33

The posterior fat pad seen on lateral view of the elbows presumptive evidence of which injury?

Back 33

Fracture the radio head

Front 34

How does one treat a felon?

Back 34

I&D

Front 35

What are the signs of flexor tenosynovitis ?

Back 35

Finger held in slight flexion, Symmetric swelling of the finger, Tenderness along the flexor tendon sheath, Pain with passive extension of the finger

Front 36

Fx of the lateral tibial plateau may be associated with injx to the ___ ___ nerve

Back 36

deep peroneal

Front 37

In pts with calcaneus fx, what other injx should be sought?

Back 37

Lumbar spine injuries (10%) and fx of lower ext, esp the tibial plateau (26%)

Front 38

What are the physical findings of nerve root involvement in patients with lumbar disc compression? L3-4, L5, S1

Back 38

L3-4 abn knee jerk
L5 abn dorsiflexion of great toe
S1 abn plantar flexion plus numbness of lat foot

Front 39

What cervical spine injury occurs as the result of axial loading

Back 39

Jeffersion fx (C1 ring blowout fx)

Front 40

Diagnosis of a simple pneumothrorax is easily made on an ______ ______ of the chest

Back 40

expiratory view

Front 41

How does one differentiate pulmonary contusion from ARDS?

Back 41

Pulmonary contusion occurs within minutes of injury. The infiltrate or consolidation is usually localize to pulmonary segment or lobe. ARDS is associated with delayed onset (24 to 72 hours after injury)

Front 42

Death from drowning is due to _____.

Back 42

hypoxia

Front 43

What is the most common cause of fetal death following blunt trauma in a pregnant pt?

Back 43

Abruptio placenta