مبروك ل @zharaalabdullah فوزها بكتاب Top Knife حيث كانت الأقرب للعلامة الكاملة ب ١١ جواب صحيح من أصل ١٢ سؤال في محاضرة Trauma MCQs

سأضع الاسئلة والأجوبة لاحقا هنا تحت التغريدة.

Will post the questions for maximum benefit.

Q.1 similar to the unfortunate scenario I presented, a penetrating left subclavian artery injury; your first step among the mentioned options is getting a chest XRAY. That will guide you then to insert a chest tube or to open the chest immediately. Along with hemodynamic status.

A bit tricky, Lt. subclavian is better approached via Lt. anteriolateral thoracotomy for better proximal control. And we posted the evidence from TRAUMA 8th ed. A trap door incision might also be needed. Worst case scenario? Ligate the vessel but don’t let your patient untouched.

Internal iliac artery ligation will be of minimum consequences, even when it’s bilateral ligation.

And yes please, never ligate SMA or the infrarenal aorta!

Correct answer: debridement and primary anastomosis. It might seems tempting to do right hemicolectomy , but, young, stable, minimal contamination>>> even with destructive injury, give it a try.

Seat-belt injury, Chance fracture, whiplash injury, acceleration deceleration injury: THINK ABOUT Duodenal perforation and bucket handle bowel injury.

Correct answer : duodenal perforation. ( note: the vessel below the perforated DJ junction is the SMA :) )

Correct answer : B

In lengthy questions the choice that has ( cannot be done) like choice A is usually incorrect.

Correct answer : E (palpable thrill )

Answer is : D (30-40% ) - beware of the base deficit which is an important marker of acidosis and ongoing bleeding -

Commonly repeated question: the answer is laparotomy, lacerated aorta management comes next and will tolerate hypotension.

Read carefully ( which one is relative rather than absolute indication) , all of them mandates exploration except pneumothorax. ( answer is D )

In trauma , mobalizing the splenorenal and splenophrenic ligaments comes first. Then mobalizing the spleen medially, then tying the short gastric vessels. And finally cutting the splenocolic ligament.