Trauma 6
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Questions and Answers

What is the best indicator of renal trauma?

  • Lower rib fractures
  • Back pain
  • Abdominal pain
  • Hematuria (correct)

    • What is the recommended imaging for patients with hematuria suspected of renal trauma?

  • X-ray
  • Abdominal CT scan (correct)
  • Ultrasound
  • MRI

    • What is the recommended action if pulse is weak in a patient with long bone fracture or dislocation?

  • Angiography in OR
  • Go to OR for vascular bypass or repair
  • Immediate reduction of fracture or dislocation (correct)
  • CT angio

    • What is the high-risk complication associated with femoral neck fractures and hip dislocations?

    <p>Avascular necrosis</p> Signup and view all the answers

    What type of fractures are associated with upright falls, according to the text?

    <p>Calcaneus, lumbar, and distal forearm fractures</p> Signup and view all the answers

    What is the most common cause of renal trauma?

    <p>Blunt trauma</p> Signup and view all the answers

    What is the common association of bladder trauma?

    <p>Pelvic fractures</p> Signup and view all the answers

    What is a common cause of ureteral trauma?

    <p>Penetrating injuries</p> Signup and view all the answers

    How can urethral trauma be diagnosed?

    <p>Retrograde urethrogram</p> Signup and view all the answers

    What is a potential consequence of placental abruption?

    <p>Fetal death</p> Signup and view all the answers

    What is the primary focus in trauma management during pregnancy?

    <p>Prioritizing the mother's life</p> Signup and view all the answers

    What is a likely indication for C-section during exploratory laparotomy for trauma?

    <p>Persistent maternal shock</p> Signup and view all the answers

    What is the most common cause of uterine rupture?

    <p>Posterior fundus location</p> Signup and view all the answers

    What is a potential consequence of trauma to the genitalia?

    <p>Fractures in erectile bodies and testicular trauma</p> Signup and view all the answers

    What imaging technique can be used to assess the contralateral kidney's functionality before immediate surgery without an abdominal CT scan?

    <p>IVP (Intravenous pyelogram)</p> Signup and view all the answers

    What percentage of renal injuries are treated nonoperatively?

    <p>95%</p> Signup and view all the answers

    How is left renal vein different from the right renal vein?

    <p>Has adrenal and gonadal vein collaterals, while the right renal vein does not.</p> Signup and view all the answers

    What is the recommended immediate action if pulse is weak in a patient with long bone fracture or dislocation?

    <p>Perform immediate reduction of fracture or dislocation and reassess pulse</p> Signup and view all the answers

    What is the management exception for knee dislocations in trauma cases?

    <p>All knee dislocations need to go for formal angiogram</p> Signup and view all the answers

    What type of fractures are associated with upright falls, according to the text?

    <p>Calcaneus, lumbar, and distal forearm fractures</p> Signup and view all the answers

    What is the most common cause of renal trauma?

    <p>Blunt trauma</p> Signup and view all the answers

    What is the best indicator of renal trauma according to the text?

    <p>Hematuria</p> Signup and view all the answers

    What imaging technique is recommended for all patients with hematuria suspected of renal trauma?

    <p>Abdominal CT scan</p> Signup and view all the answers

    In which orthopedic emergency would a patient require immediate reduction of fracture or dislocation and reassessment of pulse?

    <p>Dislocations or fractures with vascular compromise</p> Signup and view all the answers

    What are patients with femoral neck fractures and hip dislocations at high risk for?

    <p>Avascular necrosis</p> Signup and view all the answers

    What is associated with renal trauma according to the text?

    <p>Lower rib fractures</p> Signup and view all the answers

    What type of falls are associated with calcaneus, lumbar, and distal forearm fractures according to the text?

    <p>Upright falls</p> Signup and view all the answers

    What is the recommended treatment for anaphylaxis caused by beestings?

    <p>EpiPen (epinephrine)</p> Signup and view all the answers

    What is the initial treatment for hypothermia?

    <p>Warm air conduction (Bair Hugger)</p> Signup and view all the answers

    What is the recommended treatment for black widow spider bites?

    <p>IV calcium gluconate</p> Signup and view all the answers

    What is the primary treatment for wild animal bites?

    <p>Rabies prophylaxis</p> Signup and view all the answers

    What can result from electrical injuries?

    <p>Rhabdomyolysis and compartment syndrome</p> Signup and view all the answers

    What are the symptoms of snakebites?

    <p>Shock, bradycardia, and arrhythmias</p> Signup and view all the answers

    What is the most common cause of immediate death mentioned in the text?

    <p>Cardiac arrest from ventricular fibrillation</p> Signup and view all the answers

    What is the recommended treatment for brown recluse spider bites?

    <p>Dapsone</p> Signup and view all the answers

    What is the recommended treatment for snakebites?

    <p>Stabilize patient, anti-venin, tetanus shot</p> Signup and view all the answers

    What can result from beestings?

    <p>Anaphylaxis causing wheezing, rash, hypotension (vasomotor shock)</p> Signup and view all the answers

    What is the recommended approach for managing 95% of renal injuries?

    <p>Nonoperative management</p> Signup and view all the answers

    What imaging technique is used to diagnose bladder rupture?

    <p>Cystogram</p> Signup and view all the answers

    What is a key indicator of bladder trauma?

    <p>Hematuria</p> Signup and view all the answers

    How can ureteral injuries be diagnosed?

    <p>Multiple imaging tests</p> Signup and view all the answers

    What imaging method can be used to check for leaks during exploration for renal trauma?

    <p>Methylene blue dye</p> Signup and view all the answers

    What is the recommended diagnostic procedure for urethral trauma?

    <p>Retrograde urethrogram</p> Signup and view all the answers

    Study Notes

    Trauma Management in Urology and Obstetrics

    • IVP can be used to assess the contralateral kidney's functionality before immediate surgery without an abdominal CT scan
    • Left renal vein can be ligated near the IVC and has adrenal and gonadal vein collaterals, while the right renal vein does not
    • 95% of renal injuries are treated nonoperatively and not all urine extravasation injuries require surgery
    • Bladder trauma is often associated with pelvic fractures and can be indicated by hematuria, meatal blood, or sacral/scrotal hematoma
    • Ureteral trauma is most commonly caused by penetrating injuries and requires different management approaches based on the location and extent of the injury
    • Urethral trauma is typically associated with blunt trauma and can be diagnosed using a retrograde urethrogram
    • Trauma management during pregnancy involves prioritizing the mother's life, estimating pregnancy based on fundal height, and identifying indicators of fetal maturity
    • Placental abruption can result in fetal death and is often caused by shock or mechanical forces
    • Uterine rupture is more likely to occur in the posterior fundus and may require aggressive resuscitation, especially if it happens after delivery
    • Indications for C-section during exploratory laparotomy for trauma include persistent maternal shock, pregnancy near term, and mechanical limitation to life-threatening vessel injury
    • Trauma to the genitalia can result in fractures in the erectile bodies and testicular trauma, which may require repair if necessary
    • Management of ureteral injuries includes using IV indigo carmine or IV methylene blue to check for leaks and considering the blood supply based on the location of the injury

    Trauma Surgery: Renal, Bladder, Ureteral, Urethral, and Pregnancy-Related Injuries

    • Intraoperative identification of functional contralateral kidney via IVP can impact decision-making in renal trauma
    • Left renal vein can be ligated near IVC, while right renal vein lacks adrenal and gonadal vein collaterals
    • Nonoperative management is the preferred approach for 95% of renal injuries
    • Methylene blue dye can be used to check for leaks during exploration for renal trauma
    • Hematuria is a key indicator of bladder trauma, often associated with pelvic fractures
    • Cystogram is used to diagnose bladder rupture, with different treatment approaches for extraperitoneal and intraperitoneal ruptures
    • Hematuria is unreliable in diagnosing ureteral trauma, requiring multiple imaging tests for accurate diagnosis
    • Ureteral injuries may require different approaches based on the location and size of the segment missing
    • Urethral trauma is often associated with pelvic fractures and requires a retrograde urethrogram for diagnosis
    • Repair of significant urethral tears is delayed for 2-3 months to reduce the risk of complications
    • Pregnant trauma patients should be managed with a focus on maternal well-being, estimating pregnancy and monitoring fetal health
    • Placental abruption is a serious concern in trauma during pregnancy, requiring close monitoring and potential intervention if indicated

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    Description

    Test your knowledge of managing orthopedic emergencies, including femur fractures, pelvic fractures, spine injuries, and hip dislocations. Learn about the risks of avascular necrosis and the immediate steps to take in cases of lost or weak pulses.

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