18361833
Descripción
Test por Med Student , actualizado hace más de 1 año
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Creado por Med Student
hace alrededor de 5 años
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Pregunta 1
Pregunta
Flashcards at
https://quizlet.com/_6rwjjn
Respuesta
- True
- False
Pregunta 2
Pregunta
How many types of pneumothorax are there?
Respuesta
-
two
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three
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four
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five
Pregunta 3
Pregunta
What is the initial management of an open pneumothorax?
Respuesta
-
no emergency treatment is needed
-
suture of the wound
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promptly closing the defect with a sterile occlusive dressing
-
emergency thoracotomy
Pregunta 4
Pregunta
Which of these statements is true for the tension pneumothorax?
Respuesta
-
we should wait for the chest x-ray to confirm the diagnosis before proceeding with the treatment
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the mediastinum is shifted to the opposite side, decreasing the venous return and compressing the opposite lung
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it results from large defects. of the chest wall that remain open
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the treatment is emergency thoracotomy
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all of the above
Pregunta 5
Pregunta
What other condition can be initially confused with tension pneurnothorax?
Respuesta
-
flail chest
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open pneumothorax
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myocardial infarction
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cardiac tamponade
Pregunta 6
Pregunta
A teenage boy falls from his bicycle and is run over by a truck. On arrival in the emergency room, he is awake and alert and appears frightened but in no distress. The chest radiograph suggests an air-fluid level in the left lower lung field and the nasogastric tube seems to coil upward into the left chest. The next best step in management is
Respuesta
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Placement of a left chest tube
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Immediate thoracotomy
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Immediate celiotomy
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Esophagogastroscopy
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Removal and replacement of the nasogastric tube; diagnostic peritoneal lavage
Pregunta 7
Pregunta
A 25-year-old woman arrives in the emergency room following an automobile accident. She is acutely dyspneic with a respiratory rate of 60 breaths/min. Breath sounds. are markedly diminished on the right side. The first step in managing the patient should be to
Respuesta
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Take a chest x-ray
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Draw arterial blood for blood gas determination
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Decompress the right pleural space
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Perform pericardiocentesis
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Administer intravenous fluids
Pregunta 8
Pregunta
A 25-year-old woman arrives in the emergency room following an automobile accident. She is acutely dyspneic with a respiratory rate of 60 breaths/min. Breath sounds. are markedly diminished on the right side.
A chest x-ray of this woman before therapy would probably reveal
Respuesta
-
Air in the right pleural space
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Shifting of the mediastinum toward the right
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Shifting of the trachea toward the right
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Dilation of the intrathoracic vena cava
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Hyperinflation of the left lung
Pregunta 9
Pregunta
A 23-year-old previously healthy man presents to the emergency room after sustaining a single gunshot wound to the left chest. The entrance wound is 3 cm inferior to the nipple and the exit wound is just below the scapula. A chest tube is placed that drains 400 mL of blood and continues to drain 50-75 mtL/h during the initial resuscitation. Initial blood pressure of 70/0 mm Hg responds to 2 L crystalloid and is now 100/70 mm Hg. Abdominal examination is “unremarkable. Chest x-ray reveals a reexpanded lung and no free air under the diaphragm. The next management step should be
Respuesta
-
admission and observation
-
peritoneal lavage
-
exploratory thoracotomy
-
exploratory celiotomy
-
local wound exploration
Pregunta 10
Pregunta
Regarding myocardial contusion from blunt chest trauma, which of the following statements is correct?
Respuesta
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Elevated cardiac isoenzyme levels sensitively identify patients at risk for life-threatening arrhythmias
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The majority of patients have abnormalities on the initial ECG post injury
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First-pass radionuclide angiography (RNA) and echocardiography are considered the “gold standard” for diagnosis
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RNA and echocardiography are good predictors of subsequent Cardiac complications such as arrhythmias and pump failure
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All patients diagnosed with myocardial contusion should be monitored in an intensive care unit setting for 72 h
Pregunta 11
Pregunta
Which of the following situations would be an indication for performance of a thoracotomy in the emergency room?
Respuesta
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Massive hemotharax following blunt trauma to the chest
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Blunt trauma ‘to multiple organ systems with obtainable vita! signs in the field but none on arrival in the emergency roam
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Rapidly deteriorating patient with cardiac tamponade from penetrating thoracic trauma
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Penetrating thoracic trauma and no signs of life in the field
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Penetrating abdominal trauma and no signs of life in the field
Pregunta 12
Pregunta
How do we define a massive hemothorax?
Respuesta
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accumulation of more than 300 ml of blood
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accumulation of more than 1000 ml of blood
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accumulation of more than 1500 ml of blood
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accumulation of more than 2500 ml of blood
Pregunta 13
Pregunta
What is the initial treatment of hemothorax?
Respuesta
-
a rapid crystalloid infusion
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insertion of a chest tube
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blood transfusions as soon as possible
-
all of the above
Pregunta 14
Pregunta
What is the definition of flail chest?
Respuesta
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multiple rib fractures in one fracture line
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accumulation of more than 1500 ml of blood in the thoracic cavity
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multiple rib fractures - three or more ribs fractured in two or more places
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one rib fractured in two fracture lines
Pregunta 15
Pregunta
What causes the. greatest physiologic insult in patients with flail chest?
Respuesta
-
the multiple rib fractures
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the abnormal chest wall movement
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the massive blood loss
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the pulmonary contusion
Pregunta 16
Pregunta
What is the mast important part in the treatment of patients with pulmonary contusion?
Respuesta
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emergency thoracotomy
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treatment of posttraumatic lung infection
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observation and follow-up
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blood transfusions
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all of the above
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