Trauma/Emergencies — Flashcards

Flashcard 261: Testicular torsion is a pathology of the testes that is associated with _____ symptoms

Answer: GI

Flashcard 262: Poor _____, severe _____ failure, and _____ are contraindications to **elective** surgery

Answer: nutrition

Extra: Contraindications (or reasons to delay) elective surgery include: - **Nutrition**: Albumin < 3, weight loss > 20% in 6 months. - **Liver**: Child-Pugh Class C (Bilirubin > 4, Albumin < 2, PT > 16, ascites, or encephalopathy). - **Smoking**: Stop 8 weeks prior to surgery to minimize pulmonary risk. - **Cardiac**: EF < 35% (absolute contraindication), MI within 6 months. - **Metabolic**: Diabetic Ketoacidosis (DKA).

Flashcard 263: What is the next step in management for a patient with a gunshot wound in the right thigh? The right lower extremity does not have hard signs / hemodynamic instability.\n_____

Answer: Ankle-Brachial Index (ABI) and CT angiography if ABI < 0.9

Extra: If **hard signs** of vascular injury are present (e.g., pulsatile bleeding, expanding hematoma, thrill/bruit, absent pulses/distal ischemia), the next step is immediate **surgical exploration**.

Flashcard 264: What is the next step in management for a patient with a new mole suspicious for melanoma? _____

Answer: Excisional biopsy (with initial margins of 1-3 mm)

Extra: Excisional biopsy should be performed with narrow margins (typically 1-3 mm) to ensure the entire lesion is captured for accurate Breslow depth measurement. Definitive wide local excision (WLE) with 1-2 cm margins is performed ONLY after a diagnosis of melanoma is confirmed.

Flashcard 265: (+) Pain, (+) blister and partial thickness burn = _____ degree burn

Answer: 2nd

Flashcard 266: Fracture of the _____ is typically associated with: - Elderly + osteoporosis - Young + trauma

Answer: hip

Flashcard 267: What trauma pathology occurs when 3 or more contiguous ribs are fractured in 2 or more places?\n_____

Answer: Flail chest

Extra: Characterized by paradoxical chest wall movement: the flail segment moves inward during inspiration and outward during expiration.

Flashcard 268: What is the management for a testicular tumor? _____

Answer: Radical inguinal orchiectomy with post-surgery chemotherapy/radiation

Flashcard 269: What is the management for a **hemodynamically stable** patient with a spleen or liver injury (identified on CT)?\n\n_____

Answer: Non-operative management (Observation)

Extra: Stable patients are managed with bed rest, serial hemoglobin levels, and serial abdominal exams. Angioembolization is indicated for stable patients with active contrast extravasation ("blush") on CT.

Flashcard 270: Pneumonectomy is considered for patients with non-metastatic lung cancer located centrally and FEV1 > _____

Answer: 2L