ABSITE TRAUMA Updated 2025 Complete Exam Questions with Elaborated Correct Answers||A+ GRADED||100% GUARANTEED PASS!!!LATEST VERSION

ABSITE TRAUMA Updated 2025 Complete Exam Questions with Elaborated Correct Answers||A+ GRADED||100% GUARANTEED PASS!!!LATEST VERSION Carboxyhaemoglobin - ANSWER A 20% level of carboxyhemoglobin produces confusion. A 5% level is normal for nonsmokers, and a 10% level is normal for smokers. At the 60% level, brain death occurs, and patients are not responsive. shoulder dislocation - ANSWER D. Evaluate neurovascular status, obtain anteroposterior and axillary shoulder radiographs to ensure that there are no associated fractures and to accurately identify the direction of dislocation, and perform a closed reduction of an anterior shoulder dislocation. A neurovascular examination is a crucial part of any musculoskeletal injury. Obtaining radiographs before a reduction is important to rule out existing fractures. Part of a traumatic shoulder injury workup is an axillary lateral radiograph to evaluate the location of the humeral head in reference to the glenoid joint. Closed reduction of the dislocation is the standard of care. DP lavage - ANSWER Diagnostic peritoneal lavage can help guide operative decision making in hemodynamically stable patients with penetrating abdominal trauma. The procedure involves insertion of a small catheter into the peritoneal cavity typically at or just below the umbilicus. If frank blood is aspirated on initial insertion, the examination is considered a positive diagnostic peritoneal aspiration, the procedure is terminated, and the patient is taken to the operating room for exploration. If no blood is aspirated, 1 L of warm saline is run into the peritoneal cavity and then drained back out. The lavage effluent is then sent for Gram stain, red blood cell count, and white blood cell count. If frank bowel contents, feces, or food is identified in the effluent, the patient needs exploration. A red blood cell count of 100,000 cells/mL or a white blood cell count of more than 500 cells/mL indicates a positive examination and the patient also requires exploration. The finding of elevated white blood cell count in the lavage effluent is concerning for bowel injury. A 60-year-old man falls from 8 feet and lands on a branch, leading to an L1 chance fracture. No intra-abdominal injuries are seen on abdominal computed tomography. The next morning, he develops abdominal tenderness and nausea. His vital signs are still stable, his hemoglobin is unchanged, and his white blood cell count is mildly increased to 14,000/µL. How should these findings be interpreted? - ANSWER The man could have an unidentified small bowel injury. Chance fractures are flexion/distraction injuries of the spine. These injuries are significantly associated with hollow viscus, mesenteric, and solid organ injury. Abdominal computed tomography (CT) did not show any intra-abdominal injuries, but CT is less capable of detecting injuries to the hollow viscera as compared to solid organ injury. In this patient with new abdominal tenderness, nausea, and leukocytosis, a hollow organ injury must be considered. A clinically significant liver laceration is less likely given the negative abdominal CT and stable hemoglobin. Although patients with spine fractures can develop ileus, an unidentified small bowel injury is more concerning in the setting of abdominal tenderness and leukocytosis. knee dislocation - ANSWER Perform a neurovascular examination, attempt reduction, confirm reduction on postreduction x-rays, repeat the examination, consider further imaging studies (eg, angiogram), and immobilize the knee. It is important to conduct an urgent neurovascular examination for suspected knee dislocation. Closed reduction is the standard of care and should be confirmed on xray before proceeding. A repeat neurovascular examination should be performed to ensure that the reduction maneuver did not disturb neurologic or vascular structures. Computed tomography angiography may be necesssary and should be decided on before the knee is formally immobilized for further workup or treatment. blunt liver injury - ANSWER Although many patients with blunt liver injury are managed successfully without surgery, predictors for failure of nonoperative management of blunt liver injury include high-grade injury, arterial pseudoaneurysm, contrast extravasation on computed tomography scan or angiography, large hemoperitoneum, and extremes of age. indication for ex lap - ANSWER Indications for exploratory laparotomy in the trauma patient include a positive focused assessment with sonography in trauma (FAST) or diagnostic peritoneal lavage in an unstable patient, peritonitis, evisceration, evidence of diaphragm rupture, persistent severe gastrointestinal bleeding, large pneumoperitoneum (suggesting hollow viscus injury), and penetrating trauma that violates the fascia. A 40-year-old man sustains a knife wound to the abdomen in a bar fight. You perform a Pringle maneuver for a deep hemorrhagic liver laceration. Which of the following is the most appropriate next step if bleeding does not abate with inflow control? - ANSWER Extensive packing with laparotomy pads Injuries to the retrohepatic vena cava and adjacent hepatic veins are notoriously difficult to manage. Retrohepatic venous or inferior vena cava (IVC) hemorrhage does not respond to inflow control (ie, Pringle maneuver). Packing is the mainstay of initial management of a severely injured liver. Mobilizing an injured liver by taking down the suspensory ligaments risks releasing containment and tamponade of a retrohepatic venous or caval injury, thereby worsening hemorrhage. The Schrock shunt is a seldom applied technique for injured retrohepatic veins or IVC because it is technically complex and not associated with favorable outcomes. Total vascular isolation (inflow occlusion, infrarenal IVC control, intrapericardial caval control, and aortic occlusion [via cross-clamping or balloon occlusion]) maintains cerebral and coronary perfusion while allowing repair of retrohepatic venous or caval injuries. However, this should be reserved for severe injuries that do not respond to packing. 70% jejunal injury - ANSWER Resection of the involved segment and anastomosis Full-thickness lacerations of the jejunum and ileum should be addressed in such a way that the intestinal lumen is not significantly narrowed. Thus, it is recommended that injuries involving less than 50% of the bowel circumference be repaired in one or two layers, whereas injuries involving greater than 50% of the bowel circumference be addressed by segmental resection. Given the patient's stability, a bowel anastomosis should be performed. indications for rib plating - ANSWER Indications for operative fixation of severely displaced fractures include (1) patients undergoing thoracotomies for associated intrathoracic injuries, (2) those who have progressive deterioration of pulmonary function despite aggressive nonoperative management, and (3) those with pulmonary contusions and associated rib fractures who are unable to be weaned from the ventilator after contusions have resolved. Operative management is also indicated for patients with significant chest wall deformity and nonunion fractures. treatment for simple pneumo prior to laproscopy - ANSWER A simple pneumothorax can be aggravated to a tension pneumothorax during the positive pressure ventilation given with general anesthesia for a diagnostic laparoscopy if a chest tube is not placed prior to intubation. injury to zone 2 neck - ANSWER The injury involves zone II of the neck (between the angle of the mandible and the cricoid cartilage) which classically has required mandatory exploration. However, in more recent practice when there are no hard signs of vascular injury, a CT angiography of the neck can provide detailed cross-sectional imaging and diagnose vascular injury. Endoscopy and bronchoscopy can be used to diagnosis tracheal and esophageal injuries when injury to these structures is suspected based on mechanism and /or CT findings. Angiography alone is seldom used to diagnose a vascular injury in a penetrating neck wound and should not be part of standard practice. However, all unstable patients with isolated penetrating neck wounds and/or patients with hard signs of vascular injury (bruit, thrill, expanding hematoma) require operative exploration of the neck The brown recluse spider bite - ANSWER The brown recluse spider is primarily located in the south central United States. After it bites a person, a papule develops, which then progresses to a lesion with central necrosis. This lesion can be mild or extensive and require evaluation by a plastic surgeon. The toxin of the spider may lead to several hematologic abnormalities that range from a coagulopathy to disseminated intravascular coagulation. post esophageal repair leak - ANSWER The patient presented has mediastinitis and is in shock. Given his presentation, he requires antibiotics, re-exploration via thoracotomy, wide drainage, and t-tube placement. If he had presented without shock and with normal vital signs and a small leak, then it would be reasonable to consider less invasive options for management. Esophagoscopy and esophageal stent placement has been shown to be successful in patients with small esophageal leaks that are hemodynamically normal. Percutaneous drainage and antibiotics along should be reserved for a very select group of patients. These patients are usually greater than 24 hours from perforation, have a small contained leak, and are hemodynamically normal. Surgically repairing the injury again, after it has already failed initial repair, and the patient is now in shock, should not be considered. IO in kids - ANSWER Intraosseous fluid infusions to replace blood volume loss are a standard part of the resuscitation for injured children. In the emergency setting, with less-than-optimal lighting, assistance, and choice of equipment, the intraosseous route does not require the precision demanded for cannulating the small vessels of children, yet provides a cannula large enough to deliver adequate volume. Although a number of osseous ports are feasible for this technique, the medial aspect of the tibia, 2 or 3 cm distal to the tibial tuberosity, is the usual site for insertion of the intraosseous needle. Colloid solutions, including blood, and crystalloids can be infused by this route. With maintenance of proper sterile procedures, infections associated with intraosseous punctures are not a problem. The intraosseous route has also been used in adults and may be the best option for adults who have no available peripheral veins when central vein cannulation or a cutdown is not an appropriate choice. traumatic diaphragm rupture - ANSWER Biliary pleural fistula is a rare and dreaded complication following traumatic diaphragmatic injury. The diagnosis is made by placement of a chest tube with evacuation of bilious content. The diagnosis can be confirmed with scintigraphy. Initial treatment includes placement of a thoracostomy tube and decompression of the biliary tree by endoscopic retrograde cholangiopancreatography with sphincterotomy, or placement of a percutaneous biliary drain.