MRCS trauma Q11-15

MRCS trauma Q11-15

MRCS questions on trauma

Q11) All of the following are complications of pelvic fracture except

a) Aortic rupture

b) Rectal perforation

c) Bladder perforation

d) Impotence


Q12) a 50 year old man with road side accident and injuries on right chest and femoral fracture, He is conscious,  BP is 80/60 , Pulse 104/min, and chest expansion is reduced. JVP is not visible and heart sounds are normal. Respiratory rate is 22/min

What does he have

a) Left heart failure

b) Fat Embolism

c) Pneumothorax

d) Fluid loss


A11

a) Aortic rupture

In the pelvis there is no aorta and bleeding occurs from external and internal iliac arteries. Rectum is present in the pelvis and may be injured. Impotence can occur due to sciatic and sacral nerves

Bladder injuries can be intra peritoneal or extra peritoneal.Intra peritoneal bladder injury requires laparotomy and repair where as extra peritoneal injury requires prolonged catheter drainage.


A12) d

Hypovolemia

After femur fracture and hypotension, 1st possibility in a question like this is fat embolism but as the respiratory rate is fine, that is ruled out. Bleeding from femur fracture can lead to massive blood loss and that is what has happened here.

This is not pneumothorax because in pneumothorax there will be respiratory compromise and JVP will be raised. 

This is also not left heart failure. Not cardiac tamponade because heart sounds are not muffled.

 

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