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Abdominal Truama MCQs- Surgical Diseases- 4th Year PMU

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Abdominal Truama MCQs- Surgical Diseases- 4th Year PMU

Question 1 of 15

1

A 22 year-old man is brought to the emergency department after falling from a 10-foot ladder, landing on his left side. He has multiple left-sided rib fractures and a pneumothorax requiring a chest tube. Physical examination of the abdomen is unremarkable. He remains hemodynamically stable throughout the primary and secondary surveys and undergoes contrast-enhanced CT scanning of the abdomen and pelvis. CT scan reveals a grade II laceration of the spleen, with no evidence of active contrast extravasation. The next appropriate step in management is

Select one of the following:

  • exploratory laparotomy with splenectomy

  • exploratory laparotomy with splenorrhaphy

  • splenic angioembolization

  • video-assisted thoracoscopy with evacuation of hemothorax

  • observation with serial abdominal examinations

Explanation

Question 2 of 15

1

What is a surgeon's greatest concern for patients who undergo nonoperative management of splenic injuries?

Select one of the following:

  • hypovolemic shock

  • spontaneous rupture

  • postsplenectomy sepsis

  • delayed rupture of the spleen

  • none of the above

Explanation

Question 3 of 15

1

Although, there are still different opinions on this matter, many agree that nonoperative management of splenic injuries should be reserved for

Select one of the following:

  • grade I injuries according to the AAST Spleen Injury Scale

  • grade II injuries according to the AAST Spleen Injury Scale

  • grade I, II and III injuries according to the AAST Spleen Injury Scale

  • grade IV injuries according to the AAST Spleen Injury Scale

  • grade V injuries according to the AAST Spleen Injury Scale

Explanation

Question 4 of 15

1

Which of these organs is the most commonly injured abdominal organ?

Select one of the following:

  • liver

  • spleen

  • lungs

  • stomach

  • pancreas

Explanation

Question 5 of 15

1

Hematoma in the spleen- subcapsular, 10% to 50% surface area; intraparenchymal, <1 5 cm in diameter corresponds to which injury grade according to the AAST Spleen Injury Scale?

Select one of the following:

  • grade I

  • grade II

  • grade III

  • grade IV

  • grade V

Explanation

Question 6 of 15

1

Which imaging test do we use first in ar unstable trauma patient with suspected abdornina trauma?

Select one of the following:

  • Plain radiograph of the abdomen

  • Focused abdominal sonography in trauma (FAST)

  • Diagnostic peritoneal lavage

  • Abdominal CT scan

  • MRI of the abdomen

Explanation

Question 7 of 15

1

Which is the primary method of imaging of the stable blunt trauma patient and has supported the evolution of the nonoperative management of many solid abdominal organ injuries?

Select one of the following:

  • Plain radiograph of the abdomen

  • Focused abdominal sonography in trauma (FAST)

  • Abdominal CT with IV administration of a contrast agent

  • Diagnostic peritoneal lavage

  • MRI of the abdomen

Explanation

Question 8 of 15

1

What complications of nonoperative management of liver traumas can we expect after the initial success?

Select one of the following:

  • bile leaks

  • biloma formation

  • hemobilia

  • liver abscesses

  • all of the above

Explanation

Question 9 of 15

1

Hematoma of the liver - subcapsular, > 50% surface area of ruptured, subcapsular or parenchymal hematoma; intraparenchymal hematoma > 10 cm or expanding corresponds to which injury grade according to the AAST Liver Injury Scale?

Select one of the following:

  • grade I

  • grade II

  • grade III

  • grade IV

  • grade V

Explanation

Question 10 of 15

1

Gastric injuries will often be identified on physical examination by

Select one of the following:

  • the presence of peritonitis

  • the evidence of shock

  • jaundice and biliary colic

  • hypovolemia

  • all of the above

Explanation

Question 11 of 15

1

What is the treatment for small hematomas of the duodenal wall?

Select one of the following:

  • duodenal transection with primary anastomosis

  • gastric decompression and initiation of total parenteral nutrition

  • primary repair using a single- or double-layer approach

  • mobilization of the duodenum with a wide Kocher maneuver

  • typically they require no treatment

Explanation

Question 12 of 15

1

The pancreas is well protected because of its retroperitoneal location. What is the commonly identified mechanism of most pancreatic injuries?

Select one of the following:

  • direct compression of the organ in the left upper quadrant of the abdomen

  • penetrating wound to the right thoracoabdominal! area

  • shearing forces, which tear pancreatic tissue

  • acute increase in intraluminal pressure from external forces

  • crushing of the body between a rigid structure and the vertebral column

Explanation

Question 13 of 15

1

Which of these organs is one of the most frequently injured organs after penetrating abdominal trauma?

Select one of the following:

  • spleen

  • pancreas

  • small intestine

  • liver

  • gallbladder

Explanation

Question 14 of 15

1

Diffuse liver bleeding due to coagulopathy will not respond to repeated attempts at placement of suture. How do we proceed in this situation?

Select one of the following:

  • we apply perihepatic packing and manual compression

  • we apply the Pringle maneuver

  • we apply a vascularized pedicle of omentum within the liver injury

  • we apply perihepatic packing and reversal of physiologic derangements in the ICU

  • none of the above

Explanation

Question 15 of 15

1

If you want flash cards go to
https://quizlet.com/_5q298a

Select one of the following:

  • True
  • False

Explanation

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