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ER/Surg 7 (trauma)

Step-2

QuestionAnswer
What is the classic ECG appearance in atrial flutter? saw tooth pattern of P waves
What side effects can arise from theophylline OD? seizures, hyperthermia (2/2 seizure), hypotension, cardiac tachyarrhythmias
What is the treatment for Kawasaki disease in the acute-phase? high dose ASA, IVIG, and DO NOT use steroids
Hypertension with bradycardia is suggestive of ____________(cushing's phenomenon). increased intracranial pressure
What should you rule out before performing any examination requiring head movement? cervical fracture and spinal cord injury
What 3 categories are evaluated in Glasgows Coma Scale(GCS)? eye opening, verbal response, motor response.
What does a GCS score of 12+ suggest? minor brain injury with probable recovery
What does a GCS score of 9-11 suggest? moderate severity requiring close observation for changes
What does a GCS score of 8 or less suggest? <=8 after 6 hours associated with 50% mortality. <8 and the patient should be intubated.
What is the basic sequence of assessing a trauma patient? ABCDE: airwary, breathing, circulation, diability(GCS), exposure(remove all clothes)
What are the classic physical exam findings in a basilar skull fracture? racoon eyes, bruising over the mastoid process(Battle's sign), blood behind the TM, CSF rhinorrhea or otorrhea
What is cushing's triad? HTN, bradycardia, bradypnea
What interventions can be used to lower intracranial pressure in a head injury pt? head of the bed at 30 degrees, mannitol(monitor serum Na and osmolarity. Hold mannitol if Na>152 or osm>305mOsm/L), intubate and hyperventilate(until pco2 25-30 on ABG), decompressive craniectomy.
A pt presents to the ER after being involved in a MVA. He does not open his eyes or make any sounds, but he does withdraw to painful stimuli. What is his GCS? What need to be done? Score of 6, he needs to be intubated to protect his airway (GCS <8 needs intubation)
MVA victim arrives @ the ER,he's able to carry on a convo & even comments on your hair. He's able to move all extremities on command, & has a significant periorbital eccymosis & surrounding superficial scrapes. What's his GCS? What imaging does he need? GCS=15, he needs a CT of the head.
What is the tx for anterior spinal cord syndrome following traumatic injury? ABCs, keep spine stable, if hypotension give fluid bolus but limit fluids once normotensive, give immediate high dose IV steroids, CT/MRI of spinal cord, once stable decompression via closed reduction or surgery.
Zone I of the neck is from ______to_________. clavicle to cricoid cartilage
Zone II of the neck is from _________to________. Cricoid cartilage to the angle of the mandible
Zone III of the neck is from _________to________. angle of the mandible to base of the skull
In cases of neck trauma which prophylactic medication type may be indicated? antibiotics may be indicated b/c of increased risk of contamination by oropharyneal flora.
What work-up is indicated for penetrating injury to zone I of the neck? 4 vessel arteriogram + triple endoscopy
What work-up is indicated for penetrating injury to zone II of the neck? surgical exploration or (doppler U/S + selective exploration)(institution dependent)
What work-up is indicated for penetrating injury to zone III of the neck? 4 vessel arteriogram
Created by: shelybel