NRSRGRY - TRM

Question 1

Leading cause of death in children and young adults

Answer 1

trauma

Question 2

True about scalp injury

a. Bleed profusely
b. For simple injury close with secondary intention
c. both
d. neither

Answer 2

A

Question 3

Fracture covered with intact skin

Answer 3

Skull fracture

Question 4

fracture associated with disrupted overlying skin

Answer 4

Open/compound fracture

Question 5

breaks in the bone that transverse the full thickness of the skull from the outer to inner table. They are usually fairly straight with no bone displacement.

Answer 5

linear fracture

Question 6

A bone fracture in which the lines of break radiate from a point, usually from the site of an injury.

Answer 6

stellate

Question 7

a fracture in which the bone has broken into several pieces.

Answer 7

Comminuted fracture

Question 8

Ecchymosis behind the ear as a sign of basal skull fracture is called

Answer 8

battle’s sign

Question 9

Periorbital ecchymosis as a sign of basilar skull fracture is called

Answer 9

raccoon’s eyes

Question 10

Immediate injury to neurons from transmission of the force of impact

Answer 10

Primary injury

Question 11

Subsequent neuronal damage due to the sequelae of trauma

Answer 11

Secondary injury

Question 12

What comprises initial assessment of closed head injuries

Answer 12

ABCD(E)
Airway
Breathing
Circulation
Disability
Exposure

Question 13

medical management of closed head injuries to decrease incidence of early post

Answer 13

Phenytoing 17 mg/kg loading dose

Phenytoin 300-400 mg/kg/day

Question 14

Peptic ulcer as a result of brain injury

Answer 14

Cushing’s ulcer

Question 15

Mild traumatic Brain injury GCS level

Answer 15

13-15

Question 16

Severe traumatic Brain injury GCS level

Answer 16

3-8

Question 17

Moderate TBI GCS level

Answer 17

9-12

Question 18

At least what GCS to intubate?

Answer 18

8 below

Question 19

temporary neuronal dysfunction following nonpenetrating head trauma

Answer 19

Concussion

Question 20

bruise of the brain occurs when the force from trauma is sufficient to cause breakdown of small blood vessels and extravasation of blood into the brain

Answer 20

contusion

Question 21

damage to axons throughout the brain due to rotational acceleration and then deceleration

Answer 21

diffuse axonal injury

Question 22

Shape of epidural hematoma on imaging

Answer 22

lenticular (biconvex)

Question 23

Shape of subarachnoid hemorrhage on imaging

Answer 23

Crescent

Question 24

Definition of brain death

Answer 24

absence of signs of brain stem function or motor response to deep central pain in the absence of systemic medical conditions that could impair brain function

Question 25

What are the criteria to declare brain death? a. 3 clinical exams 12 hours apart b. 2 clinical exams 12 hours apart c. 1 clinical exam and a confirmatory test d. 2 confirmatory tests e. A and B f. B or C g. B, C or D

Answer 25

F

Question 26

What are the clinical exams that could be performed to evaluate for brain death?

Answer 26

``` Nonreactive pupils No corneal blink reflex No oculocephalic reflex No oculovestibular reflex Loss of drive to breath ( apnea test) No response to deep central pain ```

Question 27

Positive doll's eyes

Answer 27

eyes move in the opposite direction of the head movements, and it is therefore sometimes called doll's eyes

Question 28

Positive vestibulo-ocular reflex

Answer 28

Ice cold or warm water or air is irrigated into the external auditory canal, usually using a syringe. head turn to the contralateral side. The eyes then turn toward the ipsilateral ear, with horizontal nystagmus to the contralateral ear.

Question 29

Type of neurologic spinal injury with residual motor or sensory function below the level of the lesion

Answer 29

Incomplete spinal injury

Question 30

Spinal injury that persist for >24 hours, no function below the level of injury and probability of return to function is low

Answer 30

Complete spinal injury

Question 31

True about initial assessment and management of spine injury EXCEPT a. must be considered in select patients b. a patient with no sx, referable to neurologic injury, no neck or back pain and a known mechanism of injury unlikely to cause spine injury is at minimal risk for significant injury to the spine c. trauma patient should be kept on flat board with pad s and strap for immobilization d. hard cervical collar is kept in place

Answer 31

A. in all px

Question 32

injury to the entire cord with total loss of motor and sensory function below the level of the lesion

Answer 32

cord transection

Question 33

injury to half the cord resulting in loss of motor control and proprioception ipsilaterally and loss of nociceptor and thermoception contralaterally

Answer 33

Brown Sequard sydrome

Question 34

Injury to inferior gray mater of the cord in the cervical spine with UE worse than LE

Answer 34

central cord syndrome

Question 35

Bilateral paralysis and loss of nocicpetion and thermoception

Answer 35

Anterior cor syndrome

Question 36

What plain films provide rapid survey of bony spine

Answer 36

Anteroposterior Open mouth Lateral plain films

Question 37

Definitive management for spinal cord injury

Answer 37

Spinal dose steroids Orthotic devices Surgery