General Trauma

Question 1

what does the primary survey consist of?

Answer 1

ABCDE

Question 2

when do you know if airway is clear?

Answer 2

they can speak

Question 3

what does Glasgow coma scale of 8 or less imply?

Answer 3

loss of airway control

Question 4

what should all trauma patient receive?

Answer 4

high flow oxygen (15L/min) with tight fitting mask

Question 5

how do you assess circulation and perfusion?

Answer 5

pulse rate and blood pressure

Question 6

what is the minimum accepted urine output?

Answer 6

30ml/hr

Question 7

how many people are needed for a log roll?

Answer 7

4

Question 8

what is the secondary examination?

Answer 8

head to toe examination to detect other injuries. a more thorough history of the injury can be done at this stage

Question 9

what is polytrauma?

Answer 9

where more than one major long bone is injured

Question 10

what is SIRS?

Answer 10

systemic inflammatory response syndrome

Question 11

when does SIRS occur?

Answer 11

when there is an amplification in the inflammatory cascade in response to trauma

with pyrexia,tachycardia, tachypnoea and leukocytosis

Question 12

what is ARDS?

Answer 12

acute respiratory distress syndrome

Question 13

what is MODS?

Answer 13

multiple organ dysfunction syndrome

Question 14

what is a fracture?

Answer 14

a break in a bone

Question 15

name the 2 types of fracture?

Answer 15

partial

complete

Question 16

what can cause fractures?

Answer 16

direct trauma

indirect trauma

Question 17

name the 4 steps in fracture healing?

Answer 17

1. inflammation
2. soft callus
3. hard callus
4. remodelling

Question 18

what is a transverse fracture?

Answer 18

occur with a pure bending force where the cortex on one side fails in compression and the cortex on the other side fails in tension

Question 19

what causes an oblique fracture?

Answer 19

occurs with a shearing force (fall from a height)

can be fixed with an interfragmnetary screw

Question 20

what causes a spiral fracture?

Answer 20

due to torsional forces

can be fixed with an interfragmentary screw

Question 21

what is a fracture with 3 or more fragments?

Answer 21

comminuted fractures

Question 22

what is a segmental fracture?

Answer 22

a fracture which is in 2 separate pieces

Question 23

how do you describe a fracture at the end of a long bone?

Answer 23

intra-articular
or
extra-articluar

Question 24

what does the position of a fracture depend on?

Answer 24

the displacement and angulation

Question 25

what is displacement?

Answer 25

the direction of translation of the distal fragment

Question 26

what is angulation?

Answer 26

the direction which the distal fragment points toward and the degree of its deformity (medial/lateral or anterior/posterior)

Question 27

clinical signs of a fracture?

Answer 27

localised bony tenderness swelling deformity crepitus

Question 28

what do you look at for the assessment of a fracture?

Answer 28

is it open or closed? check neurovascular status- check pulses, cap refill, temp, colour, sensation, motor power) compartment syndrome status of skin and soft tissue envelope

Question 29

what investigations would you do for a fracture?

Answer 29

``` x ray tomogram-moving xray for complex bones CT MRI-occult fractures Technetium bone scans ```

Question 30

what is the initial management of a long bone fracture?

Answer 30

splintage or immobilization

Question 31

name some early complications of farctures?

Answer 31

compartment syndrome vascular injury nerve compression injury skin necrosis

Question 32

what is the main late systemic complication of fractures?

Answer 32

PE

Question 33

signs/symptoms of fracture rehealing

Answer 33

resolution of pain and function absence of point tenderness no local oedema resolution of movement at fracture site

Question 34

signs of non-union

Answer 34

ongoing pain ongoing oedema movement at fracture site

Question 35

what is one of the slowest healing bones in the body?

Answer 35

tibia

Question 36

what can result from delayed union/

Answer 36

infection

Question 37

what is the initial management of an open fracture (in A&E)?

Answer 37

IV broad spectrum antibiotics | sterile/ antiseptic soaked dressing applied to wound

Question 38

what is mainstay of treatment for soft tissue injury?

Answer 38

RICE | rest, ice, compression, elevation to reduce initial swelling followed by early movement to prevent stiffness

Question 39

``` acute onset severe pain red hot tender joint severe pain on movement ```

Answer 39

septic arthritis

Question 40

most common bug for septic arthritis in adults?

Answer 40

S.aureus

Question 41

what bug causes septic arthritis in the IV drug abusers, the elderly and seriosuly ill?

Answer 41

e.coli

Question 42

what bug causes septic arthritis in children?

Answer 42

H. influenzae

Question 43

investigation for septic arthritis?

Answer 43

aseptic aspiration

Question 44

treatment for septic arthritis?

Answer 44

surgical wash out

Question 45

what is the min score on glasgow coma scale?

Answer 45

3

Question 46

what nerve is in danger after a colles fracture

Answer 46

median nerve

Question 47

what nerve is in danger with anterior dislocation of shouker

Answer 47

axillary nerve

Question 48

what nerve is in danger after humeral shaft fracture

Answer 48

radial nerve

Question 49

what nerve is in danger after supracondylar fracture of elbow

Answer 49

median nerve

Question 50

what nerve is in danger with posterior dislocation of hip

Answer 50

sciatic nerve

Question 51

what nerve is in danger after bumper injury to the knee

Answer 51

common peroneal nerve