Trauma And Fracture Management

Question 1

What are the 5H components in trauma?

Answer 1

Hypovolemia, hypoxia, hypokalemia/hyperkalemia, hypothermia, hypoglycemia

Question 2

What are the 5T components in trauma?

Answer 2

Tension pneumothorax, cardiac tamponade, toxins, coronary thrombosis, pulmonary thrombosis

Question 3

What is the most common cause of major trauma globally?

Answer 3

Road traffic accident (23%)

Question 4

Describe the trimodal pattern of trauma-related death.

Answer 4

1st peak: within 1h (CNS/CVS), 2nd: within 24h (hypoxia/shock), 3rd: after 24h (sepsis/MODS)

Question 5

What does ATLS stand for?

Answer 5

Advanced Trauma Life Support

Question 6

What are the ATLS primary survey steps?

Answer 6

Airway, Breathing, Circulation, Disability, Exposure

Question 7

What are signs of basal skull fracture?

Answer 7

Raccoon eyes, Battle sign, rhinorrhea, otorrhea

Question 8

What does S.A.M.P.L.E history stand for?

Answer 8

Signs/Symptoms, Allergies, Medications, Past medical history, Last meal, Events

Question 9

What is the purpose of a FAST scan?

Answer 9

To detect free fluid in the abdomen and assess IVC diameter

Question 10

What is the trauma X-ray series?

Answer 10

Cervical spine, chest, pelvis

Question 11

When is the secondary survey done in trauma?

Answer 11

After the primary survey is completed

Question 12

What is the IV fluid resuscitation rate for trauma patients?

Answer 12

20 cc/kg/hr

Question 13

What is the maximum crystalloid volume before using colloids/blood?

Answer 13

1.5 L/hr

Question 14

What is the first step in open fracture management?

Answer 14

IV antibiotics within 1 hour

Question 15

Which antibiotics are used in open fracture?

Answer 15

Cefuroxime ± Gentamicin ± Metronidazole

Question 16

What is used for wound irrigation in ED?

Answer 16

Normal saline or distilled water

Question 17

What is used for wound irrigation in OT?

Answer 17

Chlorhexidine, povidone iodine, H2O2

Question 18

Why is the patient kept NBM in open fracture?

Answer 18

Preparation for surgical debridement

Question 19

What is done post-debridement in open fracture?

Answer 19

Wound dressing and temporary stabilization

Question 20

What is the definitive treatment for open fracture?

Answer 20

Fixation ± flap or skin graft

Question 21

Define ligamentotaxis.

Answer 21

Realignment using soft tissue tension during traction

Question 22

What are the three principles of fracture management?

Answer 22

Reduce, Retain, Rehabilitate

Question 23

Compare POP and fiberglass casts.

Answer 23

POP is heavier and malleable; fiberglass is lighter and waterproof

Question 24

What are internal fixation methods?

Answer 24

Plates, screws, intramedullary nails

Question 25

What are external fixation methods?

Answer 25

External fixator devices

Question 26

Why use EF in open fractures?

Answer 26

Allows soft tissue recovery

Question 27

What is the function of a pelvic binder?

Answer 27

To tamponade pelvic bleeding

Question 28

Estimated blood loss in pelvic injury?

Answer 28

Up to 2.5 liters

Question 29

Types of traction?

Answer 29

Skin traction and skeletal traction

Question 30

Complications of open fractures?

Answer 30

Infection, delayed healing, neurovascular injury

Question 31

Signs of spinal injury in secondary survey?

Answer 31

Step deformity, bruising, tenderness

Question 32

Tools for spinal immobilization?

Answer 32

Head block, cervical collar, spinal board

Question 33

What is 'C' in ABCDE?

Answer 33

Circulation and hemorrhage control

Question 34

What to avoid during exposure in trauma?

Answer 34

Hypothermia

Question 35

What does high riding prostate on PR exam indicate?

Answer 35

Pelvic fracture with urethral injury

Question 36

Mobility aids in rehabilitation?

Answer 36

Crutches, walking frame, quadripod stick

Question 37

Define fracture disease.

Answer 37

Complications from poor fracture management

Question 38

Why reduce fractures?

Answer 38

To relieve pain and restore alignment

Question 39

How is reduction achieved?

Answer 39

Closed or open method

Question 40

Preferred imaging for spinal cord injury?

Answer 40

MRI

Question 41

Why monitor GCS in trauma?

Answer 41

Assess neurological function

Question 42

Clinical sign of flail chest?

Answer 42

Paradoxical chest wall movement

Question 43

Clinical sign of pneumothorax?

Answer 43

Absent breath sounds

Question 44

What does pelvic spring test detect?

Answer 44

Pelvic instability

Question 45

Ideal IV cannula size in trauma?

Answer 45

Large bore (14G or 16G)

Question 46

Signs of abdominal injury?

Answer 46

Guarding, distension, absent bowel sounds, wooden hard injury

Question 47

What causes crepitus on palpation?

Answer 47

Bone fragments grinding in a fracture

Question 48

When to prefer EF over IF?

Answer 48

In contaminated wounds or unstable patients

Question 49

Timeline for antibiotic administration in open fracture?

Answer 49

Within 1 hour

Question 50

What does FAST stand for?

Answer 50

Focused Assessment with Sonography in Trauma

Question 51

Why measure lactate in trauma?

Answer 51

Assess tissue perfusion and shock

Question 52

Purpose of base excess value?

Answer 52

Evaluate metabolic acidosis