July 7, 2009 | In: TRAUMA
19 SPINAL CORD INJURIES J. Paul Elliott M.D., Sanjay Misra M.D. 1. What is the difference between a spinal injury and a spinal cord injury? Show answer Spinal injuries include damage to the bone, disc, or ligaments. These injuries sometimes...
July 7, 2009 | In: TRAUMA
18 TRAUMATIC BRAIN INJURY J. Paul Elliott M.D., Sanjay Misra M.D. 1. Is traumatic brain injury (TBI) a common problem? Show answer Yes. In the United States, 1 in 12 deaths is due to injury. One third of traumatic deaths are associated with...
July 7, 2009 | In: TRAUMA
17 POSTTRAUMATIC HEMORRHAGIC SHOCK John B. Moore M.D., Ernest E. Moore M.D. 1. Are hemorrhagic shock and hypovolemic shock the same? Show answer Yes. 2. What is hemorrhagic shock? Show answer Shock exists when the cardiovascular...
July 7, 2009 | In: TRAUMA
CONTROVERSIES 28. What is the role of the pneumatic antishock garment? Show answer The military antishock trouser (MAST) has fallen out of favor in most instances. The MAST suit is valuable for patients requiring long-distance transfer who...
July 7, 2009 | In: TRAUMA
16 INITIAL ASSESSMENT Eric L. Sarin M.D., John B. Moore M.D. 1. What is the "golden hour"? Show answer The first hour after injury provides a unique opportunity to provide life-saving interventions. Because more than half of trauma deaths...
July 7, 2009 | In: GENERAL TOPICS
EXTRA-CREDIT QUESTIONS 25. Should all patients undergoing elective laparotomy receive prophylactic antibiotic coverage? Show answer No. Doing so would contribute to driving up the cost of antibiotics and their complication rate and devaluing...
July 7, 2009 | In: GENERAL TOPICS
MANAGEMENT OF SURGICAL INFECTIONS 21. What is the drug of choice for the treatment of an abscess? Show answer A knife. Surgically drain the abscess. Abscesses have no circulation of blood within them to deliver an antibiotic. The antibiotic,...
July 7, 2009 | In: GENERAL TOPICS
PROPHYLAXIS 17. Should systemic antibiotic prophylaxis be used in elective colon resection? Show answer Yes, beyond any statistical shadow of a doubt. At least two dozen clinical trials have been carried out using placebo controls against a...
July 7, 2009 | In: GENERAL TOPICS
ANTIBIOTICS 11. Are antibiotics the classic wonder drugs? Show answer Only because you wonder if they are going to work, if they are going to cause more harm than good, and if the next generation will be unaffordable or toxic. Skepticism is...
July 7, 2009 | In: GENERAL TOPICS
15 SURGICAL INFECTIOUS DISEASE Glenn W. Geelhoed M.D., M.P.H., DTMH 1. Have modern antibiotic developments controlled many, if not most, of the problems of surgical infection? Show answer No. In seriously ill surgical patients in intensive...
July 7, 2009 | In: GENERAL TOPICS
SURGICAL TREATMENT 22. If the patient is sick (and not getting better), what should be done? Show answer After fluid resuscitation, the patient's abdomen should be explored. An exploratory laparotomy has been touted as the logical conclusion...
July 7, 2009 | In: GENERAL TOPICS
LABORATORY STUDIES 15. How is a complete blood count helpful? Show answer 1. Hematocrit. If the hematocrit is high (> 45%), the patient is most likely dry or may have chronic obstructive pulmonary disease. If it is low (< 30%), the patient probably...
July 7, 2009 | In: GENERAL TOPICS
PHYSICAL EXAMINATION 7. Are vital signs important? Show answer Yes. They are vital. If heart rate and blood pressure are on the wrong side of 100 (heart rate > 100 beats/min, systolic blood pressure < 100 mmHg), watch out! Tachypnea...
July 7, 2009 | In: GENERAL TOPICS
14 PRIORITIES IN EVALUATION OF THE ACUTE ABDOMEN Alden H. Harken M.D. 1. What is the surgeon's responsibility when confronted by a patient with an acute abdomen? Show answer 1. To identify how sick the patient is 2. To...
July 7, 2009 | In: GENERAL TOPICS
13 SURGICAL WOUND INFECTION Steven L. Peterson D.V.M., M.D. 1. Why should we worry about surgical wound infection? Show answer Approximately 30 million patients undergo surgery each year in the United States, and 20% of these patients...