Q) Out of the following which will require Spinal immobilization most?
a. 22 yr Female had a high-speed motor vehicle collision who complains of backpain and no
b.16 yr male jumped from 6ft landed on both foot denies back pain and weakness
C. Gunshot injury
D. Abdominal injury
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Spinal cord injuries are a common cause of morbidity and expenditure. Mortality is associated with cervical injuries but not lower spinal cord injuries.
Motor vehicle accidents are the most common cause and gunshot injuries the least common for spinal cord injuries.
Mechanism of injury
- Blunt trauma - Direct impingement, Ischemia, compression or bleeding
- Penetrating - Laceration of spinal cord
Chance fracture - is a type of spinal cord fracture in which there is transverse fracture of all vertebral elements
1 Complete immobilisation
2. Management of associated neurogenic shock ( due to loss of sympathetic tone) with vasopressors and fluids
Sabiston page 420
Q) Penetrating injury to the abdomen, with BP 84/60, Pulse 116/min, what is the next best step in management?
b) CT Abdomen with contrast
c) Ultrasound abdomen
d) Take to OT
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Q) Commonest cause of breathing difficulty in unconscious patient is
a) Foreign body
d) Impacted teeth
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Q. Harmonic scalpel frequency of vibration is
Q) Which of the following is a clinical marker of myocardial ischemia
a) Troponin I
c) Alkaline phosphatase
d) CPK MB
Myocardial ischemia (MI) is an adverse risk factor precluding any major surgery. MI can be STEMI (ST segment elevated MI) or NSTEMI ( Non ST segment elevated MI) .................
Read On Q108
Q ) On T2 W MRI image, what appears bright
Q) Lymphatic drainage of Right adrenal gland is to
a. Para aortic group
b. Inter Aortocaval
c. Pre aortic.
d. Para Caval
a) Para-aortic lymph node.
Small lymphatic channels from both cortex and medulla drain into the hilum, from where larger calibre lymphatic emerge to drain directly into the lateral group of para-aortic lymph nodes
- arterial supply is via three adrenal arteries
- superior adrenal artery (from inferior phrenic artery)
- middle adrenal artery (from abdominal aorta)
- inferior adrenal artery (from renal artery)
- venous drainage
- adrenal veins emerge from the hilum and drain to different veins depending on the side:
- left adrenal vein drains to the left renal vein
- right adrenal gland drains to the IVC
( Grays anatomy)
Q Things to do to decrease stress in surgery all except
a. Minimal invasive Surgery
b. Afferent block.
c. 8 hours fasting
d. Early mobilization
Q) Fascial compartments of leg
A. Anterior, lateral, Superficial and deep posterior
B. Anterior, posterior, medial
C. Medial, lateral posterior
D. Anterior, medial, lateral
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Q) Isotonic fluid solution is
A. Half normal saline
B. 1/5th normal saline
C. Ringer lactate
D. Dextrose in Normal saline
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Ringer lactate and Normal saline are isotonic fluid. they are useful in replacing GI losses. Ringer lactate has a bit of potassium as well.
Body actually requires bicarbonate and not lactate. Lactate is the more stable form in IV solutions and is used, it is converted by liver into bicarbonates.
Half NS is used in replacing losses when sodium concentration is high in the body, mainly as maintenance fluid
1/5th NS is hardly used clinically
Dextrose in Saline or DNS is used for maintenance and is not isotonic
Q False in hemorrhagic shock
A. Low heart rate
B. Cold extremity
C. Due to fluid losses
D. Vascular resistance high
Q CT abdomen is equal to how many CXR
Q . In a critically ill patient best way to monitor cardiac output is by
A. Pulmonary artery catheter
B. Pulmonary vein catheter
C. Femoral artery catheter
D. Subclavian vein catheter
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