MEDI Y2S2

Question 1

Parkland formula

Answer 1

%TBSA x Weight x 4ml

Question 2

Rule of 9 for calculating burn percentage

Answer 2

Head - 9%
Each upper limb - 9%
Torso front 18%
Torso back - 18%
Each lower limb - 18%
Perineum - 1%

Question 3

Things to consider when managing a burn patient

Answer 3

Pain
Fluids
Antbiotics
Tetanus booster
Escharotomy
-  pressure relieving incisions
High metabolic needs require special nutritional supplement
Debridement
Keep operating room at 37 
-  hypothermia
-  Cardiac arrhythmias
-  coagulopathic

Question 4

Most common infections associated with burns?

Answer 4

Pseudomonal

Tetanus

Question 5

Systemic Inflammatory Response Syndrome (SIRS)

Answer 5

HR > 90
Temp < 36 or > 38
RR > 20 or PaCO2 < 32
WBC < 4 or > 12 x 10^9 or PMNs > 10%

Question 6

Steps of Wound Healing

Answer 6

Inflammatory phase
Proliferative phase
Remodeling phase

Question 7

Pre-departure Vaccinations

Answer 7

Hep A
Hep B
ADT
MMR
Varicella
Japanese encephalitis (should be considered for wet season > 1 month travel in SEA)
Yellow fever (only for sub-Saharan africa and south america)

Question 8

Sn/Sx of hyponatremia

Answer 8

Sx - mallaise, confusion

Sns - papilladema, dull reflexes

Question 9

What tumors can give you SIADH

What CNS dysfunctions&raquo_space;> SIADH

Answer 9

Small cell, Pancreatic, Prostate

Tumors, Gullian barre, Stroke

Question 10

How does cushion’s present in a child

Answer 10

growth failure

Question 11

Skin abnormalities of cushing’s

Answer 11

Bruising
Dry
Thin skin
Pigmentation

Question 12

Sexual dysfunctions of cushing’s

Answer 12

Menstrual irregularities

Low libido

Question 13

Systemic dysfunctions of cushing’s

Answer 13

Diabetes
Osteoperosis
Avascular necrosis
Infections
Psychosis
Decreased wound healing

Question 14

Why must caution be taken when evaluating for Cushings with someone on anti-epileptics

Answer 14

Because increased liver metabolism

Question 15

Risk factors for STI

Answer 15

age < 25
young age at first sexual encounter
non-barrier contraception
many partners
cervical ectopy

Question 16

Healing of fractures

Answer 16

1. Hematoma (immediately)
2. Soft callus (end of first week) - hematoma and surrounding tissue are organizing
3. Hard callus (2-3 weeks) - activated osteoprogenitor cells deposit subperiosteal trabecular of woven bone
4. Remodelling - portions not physically stressed are resorbed > callus reduces in size

Question 17

Indications for open reduction

Answer 17

NOCAST

Non-union
Open fracture
neurovascular Compromise
intra-Articular fracture
Salter-harris 3/4/5
polyTrauma

Failure to reduce close fracture
Pathologic fraction
Paraplegics

Question 18

Management of Broken Bone

Answer 18

• First aid
• Compression (bleeding)
• IV access&raquo_space; analgesia, bloods, prophylactic antibiotics
• Reduction
• Stabilisation
• Rehabilitation

Question 19

Complications of Broken Bone

Answer 19

• Delayed union / nonunion
• Malunion
• Shock
• Compartment syndrome&raquo_space; volkmann’s contracture (ischemic contraction of forearm - muscle fibrosis)
• DVT / PE
• Fat embolus
• Infection
• Visceral damage
• Nerve damage
• Soft tissue damage
• Muscular pathology
• Joint pathology
• Avascular necrosis
• Skin / SC tissue

Question 20

4 general things that cause erectile dysfunction

Answer 20

• diabetes
• peronies
• endocrine (hypogonadism)
• heme (sickle cell)

Question 21

How would you define erectile dysfunction

Answer 21

Failure to achieve / maintain erection to have satisfactory sex