Test 30 - Surgery

Question 1

When do you intubate burn patients and why?

Answer 1

Intubate when there is: burns to the face, singing eyebrows, oropharyngeal inflammation, blistering or ash in the sputum, carboxyhemoglobin is over 10%, history of being trapped in burning place

Why: supraglottic airway is extremely sensitive to heat related injury. intubate early whenever you suspect burn of upper airway or there is a chance the airway could swell and you can lose the airway.

Question 2

What is the parameter to change when a patient is hypovolemic?

Answer 2

Heart rate

Question 3

newborn with a scrotal mass. differential questions and treatment.

Answer 3

1. Is it cystic and able to transilluminate?
   Y: wait 12 months. it will likely resolve on it’s own. if not gone in 12 months, surgical repair to decrease the risk of indirect inguinal hernia.
   N: ?

Question 4

unrestrained driver in an MVC is intubated. Has low bp and tachy. unresponsive to 2L NS. CXR and FAST are normal. What does he have?

Answer 4

Pericardial tamponade - small enough amount of blood that CXR could look normal. Decrease in CO causes tachy and low bp.

Question 5

hx of knee injury 1 month ago, now presenting with limited ROM and a popping or giving out sensation.

Answer 5

suspect meniscus tear. Dx with MRI. Trt with surgery.

Question 6

What are the muscles of the rotator cuff?

Answer 6

SITS
Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Question 7

Symptoms and px of rotator cuff tear?

Answer 7

Shoulder pain after falling on an outstretched hand

Question 8

Clinical test for rotator cuff tear?

Answer 8

Passively abduct the arm above the head. Ask patient to slowly adduct arms back to sides. If damage to the rotator cuff, patients arm will appear to rapidly fall after about 90 degrees.