18190749
Descripción
Test por Med Student , actualizado hace más de 1 año
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Creado por Med Student
hace más de 5 años
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Pregunta 1
Pregunta
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
Respuesta
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exploratory laparotomy with splenectomy
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exploratory laparotomy with splenorrhaphy
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splenic angioembolization
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video-assisted thoracoscopy with evacuation of hemothorax
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observation with serial abdominal examinations
Pregunta 2
Pregunta
What is a surgeon's greatest concern for patients who undergo nonoperative management of splenic injuries?
Respuesta
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hypovolemic shock
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spontaneous rupture
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postsplenectomy sepsis
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delayed rupture of the spleen
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none of the above
Pregunta 3
Pregunta
Although, there are still different opinions on this matter, many agree that nonoperative management of splenic injuries should be reserved for
Respuesta
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grade I injuries according to the AAST Spleen Injury Scale
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grade II injuries according to the AAST Spleen Injury Scale
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grade I, II and III injuries according to the AAST Spleen Injury Scale
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grade IV injuries according to the AAST Spleen Injury Scale
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grade V injuries according to the AAST Spleen Injury Scale
Pregunta 4
Pregunta
Which of these organs is the most commonly injured abdominal organ?
Respuesta
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liver
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spleen
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lungs
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stomach
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pancreas
Pregunta 5
Pregunta
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?
Respuesta
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grade I
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grade II
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grade III
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grade IV
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grade V
Pregunta 6
Pregunta
Which imaging test do we use first in ar unstable trauma patient with suspected abdornina trauma?
Respuesta
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Plain radiograph of the abdomen
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Focused abdominal sonography in trauma (FAST)
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Diagnostic peritoneal lavage
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Abdominal CT scan
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MRI of the abdomen
Pregunta 7
Pregunta
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?
Respuesta
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Plain radiograph of the abdomen
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Focused abdominal sonography in trauma (FAST)
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Abdominal CT with IV administration of a contrast agent
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Diagnostic peritoneal lavage
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MRI of the abdomen
Pregunta 8
Pregunta
What complications of nonoperative management of liver traumas can we expect after the initial success?
Respuesta
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bile leaks
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biloma formation
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hemobilia
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liver abscesses
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all of the above
Pregunta 9
Pregunta
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?
Respuesta
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grade I
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grade II
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grade III
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grade IV
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grade V
Pregunta 10
Pregunta
Gastric injuries will often be identified on physical examination by
Respuesta
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the presence of peritonitis
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the evidence of shock
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jaundice and biliary colic
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hypovolemia
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all of the above
Pregunta 11
Pregunta
What is the treatment for small hematomas of the duodenal wall?
Respuesta
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duodenal transection with primary anastomosis
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gastric decompression and initiation of total parenteral nutrition
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primary repair using a single- or double-layer approach
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mobilization of the duodenum with a wide Kocher maneuver
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typically they require no treatment
Pregunta 12
Pregunta
The pancreas is well protected because of its retroperitoneal location. What is the commonly identified mechanism of most pancreatic injuries?
Respuesta
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direct compression of the organ in the left upper quadrant of the abdomen
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penetrating wound to the right thoracoabdominal! area
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shearing forces, which tear pancreatic tissue
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acute increase in intraluminal pressure from external forces
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crushing of the body between a rigid structure and the vertebral column
Pregunta 13
Pregunta
Which of these organs is one of the most frequently injured organs after penetrating abdominal trauma?
Respuesta
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spleen
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pancreas
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small intestine
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liver
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gallbladder
Pregunta 14
Pregunta
Diffuse liver bleeding due to coagulopathy will not respond to repeated attempts at placement of suture. How do we proceed in this situation?
Respuesta
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we apply perihepatic packing and manual compression
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we apply the Pringle maneuver
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we apply a vascularized pedicle of omentum within the liver injury
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we apply perihepatic packing and reversal of physiologic derangements in the ICU
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none of the above
Pregunta 15
Pregunta
If you want flash cards go to
https://quizlet.com/_5q298a
Respuesta
- True
- False
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