SSM TCAR EXAM LATEST
What is Kehrs sign? - ANSWERS-Pain from diahragmatic irritation
referred to the shoulder, typically the left shoulder. In a trauma patient,
Kehr's signs stronlgy suggest splenic injury
What imaging studies are used to detect splenic injury? - ANSWERS-
FAST ultrasound is a quick way to check for free fluid in the belly. CT
images solid organs nicely
Why do you need a spleen? What does it do? - ANSWERS-It's
responsible for platelet storage, RBC cleanup and immune response.
Removal of the spleen increases a lifetime risk of pneumococcal sepsis
and other serious infections
What suggests a hepatic injury? - ANSWERS-Right flank bruising
RUQ paintenderness
Abd distention/rigidity
What imaging studies are used to detect hepatic injury? - ANSWERS-
CT and FAST exam
Why are pancreatic injuries often difficult to detect with an CT or FAST
exam? - ANSWERS-It is largely a retropperitoneal organ. It is not as
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PAGE
1
, SSM TCAR EXAM LATEST
vascular as the liver and spleen and leaks digestive enzymes rather than
blood
Which abd organs are completely retroperitoneal? - ANSWERS-
Kidneys, vena cava, aorta and spine
Which organs are partially retroperitoneal? - ANSWERS-Colon,
duodenum, pancreas, ureters
How is the pancreas injured in blunt trauma? - ANSWERS-Usually
caused by direct compression of the organ against the rigid spine
Which organ is most commonly injured in the patient with penetrating
abdominal trauma? - ANSWERS-The small bowel, it is in all four
quadrants
How is the bowel injured in blunt abdominal trauma? - ANSWERS-
Hollow structures pop dues to a direct blow or hyperflexion over a fixed
object causing an increase in intrabdominal pressure
How are bowel injuires asessed? - ANSWERS-Signs of infection-fever
leukocytosis
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PAGE
2
, SSM TCAR EXAM LATEST
rebound tenderness
Free air in the belly-Hollow viscous rupture
How much blood can be put into the belly? - ANSWERS-All of it! 500-
6,000Ml or 4-5 L
What is "Damage Control" Laparotomy? - ANSWERS-It is done to stop
the bleeding.The abd is packed and left open: transfer to ICU to continue
resuscitation.
How can we keep trauma patients warm? - ANSWERS-Forced air
warmers, warm IV fluids, keep room very warm. Acidosis and
coagulopathies will not corret unless we reverse hypothermia
What are the most common postoperative problems associated with a
bowel injury? - ANSWERS-Infection-peritonitis, abscesses, sepsis
Bowel edema
Fluid Shift
What are examples of hypotonic fluids and do they stay in the
intravascular space? - ANSWERS-D5W, D5 1/2NS,
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3
, SSM TCAR EXAM LATEST
Hypotonic fluids distribute evenly throughout all compartments. 3 L of
hypotonic fluids increases vascular volume about 1 cup
What are examples of isotonic fluids and do they stay in the
intravascular space? - ANSWERS-NS, LR, Plasmalyte
Isotonic fluids stay in extracelluar space. 3L of isotonic fluids will
increase vascular volume about 3 cups
What adverse effects does IV crystalloid administration have? -
ANSWERS-It contributes to endothelial damage and capillary leakage
Volume resusciation with NS is associated with what adverse effect? -
ANSWERS-Hyperchloremic acidosis
When is hypertonic fluid used? - ANSWERS-Counteract cerebral edema
in brain injured, reduce bowel edema following paprotomy, quickly
boost volume in hemorrhaging patients.
What is an example of an isotonic colloid and how much will it increase
volume? - ANSWERS-Plasma, it will increase the volume equal to
amount given
END OF
PAGE
4
What is Kehrs sign? - ANSWERS-Pain from diahragmatic irritation
referred to the shoulder, typically the left shoulder. In a trauma patient,
Kehr's signs stronlgy suggest splenic injury
What imaging studies are used to detect splenic injury? - ANSWERS-
FAST ultrasound is a quick way to check for free fluid in the belly. CT
images solid organs nicely
Why do you need a spleen? What does it do? - ANSWERS-It's
responsible for platelet storage, RBC cleanup and immune response.
Removal of the spleen increases a lifetime risk of pneumococcal sepsis
and other serious infections
What suggests a hepatic injury? - ANSWERS-Right flank bruising
RUQ paintenderness
Abd distention/rigidity
What imaging studies are used to detect hepatic injury? - ANSWERS-
CT and FAST exam
Why are pancreatic injuries often difficult to detect with an CT or FAST
exam? - ANSWERS-It is largely a retropperitoneal organ. It is not as
END OF
PAGE
1
, SSM TCAR EXAM LATEST
vascular as the liver and spleen and leaks digestive enzymes rather than
blood
Which abd organs are completely retroperitoneal? - ANSWERS-
Kidneys, vena cava, aorta and spine
Which organs are partially retroperitoneal? - ANSWERS-Colon,
duodenum, pancreas, ureters
How is the pancreas injured in blunt trauma? - ANSWERS-Usually
caused by direct compression of the organ against the rigid spine
Which organ is most commonly injured in the patient with penetrating
abdominal trauma? - ANSWERS-The small bowel, it is in all four
quadrants
How is the bowel injured in blunt abdominal trauma? - ANSWERS-
Hollow structures pop dues to a direct blow or hyperflexion over a fixed
object causing an increase in intrabdominal pressure
How are bowel injuires asessed? - ANSWERS-Signs of infection-fever
leukocytosis
END OF
PAGE
2
, SSM TCAR EXAM LATEST
rebound tenderness
Free air in the belly-Hollow viscous rupture
How much blood can be put into the belly? - ANSWERS-All of it! 500-
6,000Ml or 4-5 L
What is "Damage Control" Laparotomy? - ANSWERS-It is done to stop
the bleeding.The abd is packed and left open: transfer to ICU to continue
resuscitation.
How can we keep trauma patients warm? - ANSWERS-Forced air
warmers, warm IV fluids, keep room very warm. Acidosis and
coagulopathies will not corret unless we reverse hypothermia
What are the most common postoperative problems associated with a
bowel injury? - ANSWERS-Infection-peritonitis, abscesses, sepsis
Bowel edema
Fluid Shift
What are examples of hypotonic fluids and do they stay in the
intravascular space? - ANSWERS-D5W, D5 1/2NS,
END OF
PAGE
3
, SSM TCAR EXAM LATEST
Hypotonic fluids distribute evenly throughout all compartments. 3 L of
hypotonic fluids increases vascular volume about 1 cup
What are examples of isotonic fluids and do they stay in the
intravascular space? - ANSWERS-NS, LR, Plasmalyte
Isotonic fluids stay in extracelluar space. 3L of isotonic fluids will
increase vascular volume about 3 cups
What adverse effects does IV crystalloid administration have? -
ANSWERS-It contributes to endothelial damage and capillary leakage
Volume resusciation with NS is associated with what adverse effect? -
ANSWERS-Hyperchloremic acidosis
When is hypertonic fluid used? - ANSWERS-Counteract cerebral edema
in brain injured, reduce bowel edema following paprotomy, quickly
boost volume in hemorrhaging patients.
What is an example of an isotonic colloid and how much will it increase
volume? - ANSWERS-Plasma, it will increase the volume equal to
amount given
END OF
PAGE
4
