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Junior Posting > Week 4 > Flashcards

Week 4 Flashcards

1
Q

Puerperal sepsis is defined as an infection of the _______ occurring at any time between __________ or _______ and _____________\

A

genital tract

rupture of membrane

labour

42 days postpartum

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2
Q

Full meaning of CTTD

A

Closed tube Thoracostomy drainage

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3
Q

A chest tube is a surgical drain that is inserted through the _______ and into the _________ or the ________ in order to remove clinically undesired substances such as ______________ , excess fluid (__________ or __________), blood (hemothorax), chyle ( _________ ) or pus ( ____________ ) from the intrathoracic space.

A

chest wall; pleural space; mediastinum

air (pneumothorax)

pleural effusion or hydrothorax

chylothorax; empyema

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4
Q

Contraindications to chest tube placement include _____________ and presence of a _______________, as well as hepatic _________________.

Additional contraindications include ___________ in the pleural space (____________).

A

refractory coagulopathy

diaphragmatic hernia

hydrothorax

scarring; adhesions

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5
Q

Contraindications to chest tube placement include _____________ and presence of a _______________, as well as hepatic _________________.

Additional contraindications include ___________ in the pleural space (____________).

A

refractory coagulopathy

diaphragmatic hernia

hydrothorax

scarring; adhesions

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6
Q

Refractory coagulopathy, defined as ______________ from multiple sites despite ___________________

A

continued bleeding

ongoing blood component administration

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7
Q

Scaling of pain

0-
2-
4-
6-
8-
10-

A

No pain
Mild pain
Moderate pain
Severe pain
Very severe pain
Worst pain imaginable

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8
Q

Spondylosis is _____-related change of the bones (vertebrae) and discs of the spine. These changes are often called __________ disease and __________. When this condition is in the ________, it’s called lumbar spondylosis.

A

age

degenerative disc; osteoarthritis

lower back

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9
Q

Osteopenia is a loss of ________________ that weakens bones. It’s more common in people older than ______, especially _______

A

bone mineral density (BMD)

50; women

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10
Q

PRN medications: The acronym PRN ( ___________ ) refers to preparations that are prescribed to be administered on _____________ rather then at ___________

A

Pro re nata

an as needed basis

scheduled intervals.

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11
Q

Parts of a long bone?

A

Articular Cartilage
Proximal epiphysis
Epiphyseal line
Metaphysis
Diphysis
Metaphysis
Distal epiphysis
Articular cartilage

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12
Q

Ossification centers of the elbow!

A

Capitellum
Radial head
Internal(medial) epicondyle
Trochlea
Olecranon
External (lateral) epicondyle

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13
Q

Compartment syndrome is defined as a _______________ within a confined compartmental space.

A

critical pressure increase

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14
Q

Compartment syndrome typically occurs following _____-energy trauma, _____ injuries, or _______ that cause vascular injury.

Other causes include iatrogenic vascular injury, ————- or _________ , ___________, and post-reperfusion swelling.

A

high; crush; fractures

tight casts or splints

deep vein thrombosis

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15
Q

In compartment syndrome , the ______ are first compromised, followed by the ————- therefore leading to _______, and then the _________ are compromised and the limb becomes ________

A

Veins; traversing nerves

Paresthesia

Artery

Ischemic

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16
Q

Clinical Features of compartment syndrome

Symptoms tend to present within ______, although it can develop up to ________ post-insult.

A

hours; 48 hours

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17
Q

The most reliable symptom of compartment syndrome is __________, disproportionate to the injury, which is not readily improved with initial measures and made worse by ________________________ traversing the affected fascial compartment.

_________ can occur, however whilst the patient may have had a neuropraxia at the time of the injury, it is the presence of evolving neurology that is most important

A

severe pain

passively stretching the muscle bellies

Parasthesia

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18
Q

In compartment syndrome

The affected compartment may feel ______ (compared to the contralateral side), but will not generally be _______ (as the fascial compartment is only ______).

A

tense; swollen

minimally distensible

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19
Q

Acute limb ischemia

often referred to as the ‘5 P’s’):

__________,__________, ____________, _________, __________

A

Pain ,Pallor , Perishingly cold, Paralysis, and Pulselessness.

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20
Q

Compartment syndrome is most common in the _______ limbs

A

lower

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21
Q

Compartment syndrome

Definitive treatment is with an emergency ___________

A

open fasciotomy

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22
Q

Fasciotomy, a procedure in which the __________ to __________ in the ________ compartment

A

fascia is cut

relieve pressure

muscle

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23
Q

A fracture is ‘open’ when there is a direct communication between _______________________.

This is most often through the _______ – however, pelvic fractures may be internally open, having penetrated in to the _________ or _________

A

the fracture site and the external environment

skin

vagina or rectum.

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24
Q

Radiological rule of 2??

A

2 views( AP and L)
2 joints (one above and one below)
2 times
2 sides

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25
Q

Cast is _______
Slab is __________

A

Hard
Soft in some parts

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26
Q

POP is very _______, but _______ with time . It is (aerated or not aerated?) and affected by __________

A

Heavy; weakens

Not aerated

Moisture

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27
Q

Scotch VS POP

scotch is made from ———-, POP is made from ________

Scotch is (lighter or heavier?)

Scotch is (stronger or weaker?)

Scotch is (cheaper or more expensive?)

Scotch is (aerated or not aerated?)

Scotch is affected by moisture (T/F?)

A

Fiberoptics; calcium gypsona

Lighter; stronger; more expensive

Aerated; F

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28
Q

Skin and skeletal traction are mostly indicated for _______- fracture and issue related with the ______

A

proximal femoral

hip

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29
Q

Period of primary bone healing

Children: ____ for UL; _____ for LL

Adults : ____ for UL; _____ for LL

A

3weeks; 6 weeks

6weeks; 12weeks

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30
Q

Stages of fracture healing

????

A

Haematoma formation
Inflammation
Proliferation of osteoblasts, neocascularization
Spongy callus
Bony callus
Remodelling

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31
Q

Ambulant means to??

A

Be mobile
To walk around

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32
Q

Malunion:

Delayed union :

Non-union:

A

Healed in abnormal anatomic position

Failure of primary bone healing to occur at 3 months

Healing fails to occur after 9months

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33
Q

7 Ps of compartment syndrome???

A

Pain
Paresthesias
Pallor
Poikilothermic
Paralysis
Pulselessness
Putrefaction

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34
Q

In compartment syndrome, ensure elevation of the affected limb

T/F

A

F

Avoid elevation of the limb

35
Q

In late treatment of lower limb injuries, it might be safer to __________, as dead muscle tends to produce ________ which leads to ________ with ______ blockage and _________

A

Amputate

Myoglobin; myoglobinuria ; glomerular

Renal failure

36
Q

Indications for amputation?

A

Dead or dying limb
Dangerous limb
Dammed nuisance

37
Q

How to know it’s a sequestrum?

A

You won’t be able to see the medullary cavity

38
Q

A cloaca in bone is a ____________ of a bone affected by chronic osteomyelitis

A

gap in the cortex

39
Q

Following healing , recurrence is common in _________ ulcers

A

Venous

40
Q

Venous disease is responsible for _______% of all ulcers in the lower leg

A

60-70

41
Q

Majority of ulcers develop in the _____ side of ulcers

Venous Ulcers rarely extend into ________ or _______

A

Medial

Foot or upper calf

42
Q

Wagner grading of Ulcers

0-
1-
2-
3-
4-
5-

A

At risk; pre-ulcer

Superficial ulcer: skin and subcut tissue

Deeper to subcut, expose soft tissue, bone

Abscess formation

Gangrene of part

Gangrene of whole area

43
Q

Spurious hematuria is ???

A

False hematuria

44
Q

causes of spurious hematuria include _____________ and ___________ in women.

A

urinary contamination from menstruation and sexual intercourse

45
Q

A normal range of PCV

In females, _______ to ____%.
In males, ____% to _____%

A

35.5 to 44.9%.
In males, 38.3% to 48.6%

46
Q

The normal Hb level for males is _____ to _____/dl; that for females is _____ to _____ g/dl

A

14 to 18 g/dl

12 to 16 g/dl

47
Q

A normal platelet count in adults ??

A normal wbc count in adults?

A normal rbc count in adults?

A

150,000 to 450,000 platelets per microliter of blood

4000-11000 wbc per microliter

4.5-5 million rbc per microliter

48
Q

Normal PSA level?

A

0-4ng/ml

49
Q

A trimodal distribution of trauma deaths describes three peaks of deaths following trauma: ———,_______, and _________ deaths.

A

immediate, early and late

50
Q

Immediate death
(Occurs within _______ of injury)

Early death
(Occurs within ___________)

Late death
(Occurs _________ after injury)

A

minutes

hours of arrival into hospital

day to week

51
Q

Causes of immediate death

____________ injury

___________ from injuries

A

Irreversible brain

Hemorrhage

52
Q

Triage TAGS

Red (________) – _____________ injury patients

Yellow ( _________ )-_________ injured patients

Green (__________ patient) – ________________ injury

Black (_________) – _____________ patients

A

immediate; Most critical

Delayed; Less critically

ambulatory; No life or limb threatening

expectant; dead or moribund

53
Q

Factors used in TRIAGE

Mnemonic??

Full thing??

A

SLUT

Severity of injury
Likelihood of survival
Urgency of care

54
Q

Deadly six fall under ???

Immediate or early or late causes of death?

A

Early

55
Q

A crystalloid fluid is an ________ solution of ________ and other small, water-soluble molecules.

A

aqueous

mineral salts

56
Q

Other commercially available crystalloid fluids include:
____________
__________/__________ solution (lactate buffered solution)
__________ solution.
________ and _________solution.
Acetate and gluconate buffered solution.
__________(hypotonic solution)
________ (hypertonic solution)
___________ in water.

A

Normal saline

Lactated Ringer’s/Hartman’s

Acetate buffered

Acetate and lactate buffered

0.45% NaCl

3% NaCl

5% Dextrose

57
Q

Assessment of airways?

Assessment of breathing?

A

Voice, breath sounds

Respiratory rate, chest wall movements,lung auscultation, pulse oximetry

58
Q

Assessment of Circulation

A

Skin color, sweating , pulse rate, capillary refill time ,blood pressure, heart auscultation

59
Q

The normal pulse for healthy adults ranges from ____ to _____ beats per minute.

The normal respiratory rate for an adult at rest is _____ to _____ breaths per minute

Normal SPO2 is ???

A

60 to 100

12 to 20

97-100%

60
Q

Tetanus antiserum provides (temporary or permanent ?) (active or passive?) immunity against tetanus for _______

A

Temporary

Passive

2 weeks.

61
Q

Anti Tetanus Serum I.P.(A T S)

It is used for _______________ Tetanus. ATS is a solution of purified antibodies prepared from ___________

A

both preventing and curing

Equine Blood.

62
Q

Various interventions have been utilized for prophylaxis of ______________(VTE) .

These include mechanical devices such as _________________ (GCS), _____________ (IPC) devices, and pharmacologic agents such as unfractionated heparin, low-molecular-weight heparin, and fondaparinux.

A

venous thromboembolism

graduated compression stockings

intermittent pneumatic compression

63
Q

Remember that halving airway radius leads to a _____ fold increase in resistance ( ____________ law)

A

16; Poiseuille’s

64
Q

A/An ___________ sample is key to appreciating the clinical state and subsequent efficacy of treatment in patients with respiratory compromise

A

arterial blood gas (ABG)

65
Q

If you think your patient is not breathing effectively or at all but still has a pulse, then this is a _____________ and immediate help in the form of a cardiac arrest team should be sought while you and a colleague use a bag-valve-mask to oxygenate the patient.

A

respiratory arrest

66
Q

When transfusing in a state of shock, Be careful not to run through bags with added ___________ ‘stat’, as rapid boluses of ________ can cause cardiac arrest.

A

potassium chloride; potassium

67
Q

‘Pinpoint’ or bilaterally constricted pupils (miosis) may indicate __________

Anisocoria (a__________________ pupil) can occur with ___________________ , affecting ————-

A

opioid toxicity

unilaterally dilated (mydriasis)

rising intracranial pressure

CN III

68
Q

Myositis ossificans is a reaction to a ____________ that has been injured.

During the healing of the bruise, _________ can become deposited in the bruise causing a ___________ within the ________.

A

bruise in a muscle

calcium; hard bone like structure

muscle

69
Q

Infection vs Colonization

Infection means that germs are in or on the body and __________, which results in _______ and _______

Colonization means germs are on the body but ____________. People who are colonized will have _____________

A

make you sick; signs and symptoms

do not make you sick; no signs or symptoms.

70
Q

Pathogenesis of osteomyelitis

Blood stream invasion in children

Infection starts in the vascular _________ of the long bone (due to arrangement of the blood vessels at that area) >- __________

Relative _________ and consequent lowered _________ favour the bacteria

• Structure of the vessels in this area also allow bacteria to move more easily through and to adhere

A

metaphysis; hairpin loops

vascular stasis; Oxygen tension

71
Q

Pathogenesis of osteomyelitis

In adult
• Haematogenous spread account for only ______%
• Affect mostly the ________

A

20

vertebrae

72
Q

PATHOGENESIS
• Progress of acute OM

• _________ - __________ - Bone _________ - Reactive _____________ which could either lead to
• _____________ or ____________

A

Inflammation
Suppuration
Bone necrosis
new bone formation
Resolution and healing
Intractable chronicity

73
Q

Differential diagnosis of acute osteomyelitis

• ________
• Acute _____________
• Streptococal ______________
• ________________

A

Cellulitis
• Acute suppurative arthritis
• Streptococal necrotizing myositis
• Sickle cell crisis

74
Q

Complications of acute OM

•________________
•____________ fracture
•_________ infection
• Suppurative ________
•___________ damage

A

Chronic osteomyelitis

Pathological

Metastatic

arthritis

Epiphyseal

75
Q

Subacute osteomyelitis

_________ than acute om

organisms are (more or less?) virulent or patient (more or less ?) resistant

A

Milder

Less; more

76
Q

Subacute OM is a rare occurrence

T/F

A

F

No longer rare

77
Q

Subacute OM

haematogeneous
Pathology - well defined _____ in __________- _______ abscess

A

cavity

cancellous bone

brodie’s abscess

78
Q

Clinical features of Subacute OM

Pain near ______ for ________

__________

Slight _________, muscle ________, local ____________

Temperature is _______

A

Joint; several weeks

Limping; swelling; wasting

tenderness; normal

79
Q

Diagnosing chronic osteomyelitis

Recurrent ______________
Previously _______________
Occasional _________________

A

discharging sinus

healed scars

acute flare

80
Q

Saucerization

an operation in which ________ to form a saucer-like __________

Usually done when ______ is infected .

A

tissue is cut away from a wound

depression

Bone

81
Q

management of chronic OM

Antibiotics
• Local treatment
• Operations
•Wound debridement:________,________
+ _________ Management
•_________

A

saucerizations
sequestrectomy

dead space

amputation

82
Q

Treatment of subacute OM

  • __________ and _________
    •_______ may be necessary
A

immobilization and antibiotics

Curretage

83
Q

Bone curettage refers to the removal of bone through that act of _____________

A

scraping it with a curette.

Junior Posting (35 decks)

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