OB/Gyn, AMS, procedures, ortho

Question 1

Physiologic changes in pregnancy

Answer 1

Blood volume inc 50%
HR increased 10-15%
RR increased 10-15%
CO increased
BP decreased or normal (only thing that stays relatively normal)

Question 2

Pre E without severe features

Answer 2

BP > 140 or >90 diastolic AND proteinuria

Question 3

Pre-eclampsia with severe features

Answer 3

BP >160 systolic or >110 systolic OR HTN meeting criteria for pre e and evidence of end organ damage

Question 4

APGAR

Answer 4

Appearance (color): blue (0), extremities blue body pink (1), pink (2)
Pulse: absent (0), < 100 (1), > 100 (2)
Grimace (reflex irritability): no response (0), grimace or weak cry (1), vigorous cry (2)
Activity (tone): floppy (0), some flexion (1), well flexed (2)
Respiration: Apneic (0), slow (1), strong cry (2)

Question 5

Minor trauma may cause what in pregnancy

Answer 5

Placental abruption

Question 6

Attach what to BVM to deliver oxygen weather squeezing bag or not?

Answer 6

PEEP
ideally self inflating bag

Question 7

LMA vs Igel

Answer 7

Igel has no balloon

Question 8

Pediatric ET tube size

Answer 8

4 + (age / 4)

Question 9

Pediatric ET tube depth

Answer 9

(Age / 2 ) + 12

Question 10

What is Drug Facilitated Intubation

Answer 10

Use of IV sedative and/or neuromuscular blocking agents to facilitate ETI in patient with intact protective airway reflexes
- i.e RSI, RSA
-increases first past success rate

Question 11

Humerus fx, what artery and nerve can get injured

Answer 11

Axillary

Question 12

Most commonly fractured long bone

Answer 12

Tibia

Question 13

Highest risk of hemodynamic instability in what pelvic fx mechanism

Answer 13

AP injury

Question 14

3 ortho injury areas at highest risk for neurovascular injury

Answer 14

1. Hip
2. Knee
3. Elbow

Question 15

When is a traction splint contraindicated? When done?

Answer 15

Done for isolated mineshaft femur fx
Contra: known or suspected pelvic fx, knee fx, mangled limb

Question 16

Traction splint nerve risk

Answer 16

Peroneal nerve

Question 17

Trauma priorities prehospital vs hospital

Answer 17

Differing priories
Scene safety
MOI assessment
Scene oversight

Question 18

Revised trauma score uses what

Answer 18

GCS + Systolic BP + RR

Question 19

Phases of mgmt in extracation

Answer 19

1. Arrival and size up
2. Hazard control
3. Patient access
4. Medical treatment
5. Disentanglement
6. Patient packaging
7. Removal/transport

Question 20

High risk intrusion

Answer 20

12-18 inches

Question 21

Turnkeys trimodal approach

Answer 21

Approach to death and disability in trauma
3 phases when injured patients most likely to die
Initial: immediate death
Secondary: 2-3 hours after injury - bleeding or physiologic disruption (potentially reversible)
Third risk: days later, sepsis

Question 22

Red vs yellow CDC trauma center guidelines

Answer 22

Red: Anatomic and physiologic (injury patterns and mental status and vital signs) (high risk)
Yellow: MOA And EMS judgement

Question 23

First step in SALT

Answer 23

Walk - assess 3rd
Wave - assess 2nd
Still - assess 1st

Question 24

4 steps for trauma triage

Answer 24

1. Physiologic
2. Anatomic
3. Mechanism
4. Special considerations

Question 25

Spine board increases risk of death in what type of trauma

Answer 25

Penetrating trauma

Question 26

Pediatric rule of 9s

Answer 26

Head - 18
Trunk front - 18
Trunk Back - 18
Legs - 14 each
Arms - 9 each

Question 27

2 burn center referral criteria in old and new list

Answer 27

1. Burns that involved the face, hands, feet genitals, perineum, or major joints
2. Inhalation injuries

Question 28

Brooke formula for burns

Answer 28

2 ml/kg x TBSA in first 24
3 ml/kg in children

Question 29

Burn rule of 10s

Answer 29

(%TBSA x 10) to calculate initial rate for patients weighing 40-80 kg
Increase fluid rate by 100 ml/h for every 10kg of body weight over 80 kg

Question 30

Two type of crush injuries

Answer 30

Axial: traumatic asphyxia and suffocation
Appendicular: crush syndrome and compartment syndrome

Question 31

Compartment pressures for compartment syndrome

Answer 31

< 10 mmhg normal
30-50 can cause tissue toxicity over a few hours
Delta P less than 20-30

Question 32

Crush injury labs

Answer 32

Hyper K
Hypocalcemia
Acidosis

Question 33

What from compartment syndrome can cause DIC

Answer 33

Thromboplastin release