USMLE STEP 2 CK PRACTICE
QUESTIONS AND ANSWERS
penetrating trauma to the neck - zone 3 - CORRECT
ANSWER-zone 3 is angle of mandible and above -> triple
endoscopy - direct laryngoscopy, bronchoscopy, and
esophascopy at the time of initial evaluation.
p...
penetrating trauma to the neck - zone 3 - CORRECT
ANSWER-zone 3 is angle of mandible and above -> triple
endoscopy - direct laryngoscopy, bronchoscopy, and
esophascopy at the time of initial evaluation.
penetrating trauma to the neck- zone 1 - CORRECT ANSWER-
zone 1 is at the cricoid cartilage and below. aortography is
necessary.
penetrating trauma to the neck - zone 2 - CORRECT
ANSWER-zone 2 is between the angle of the mandible and the
cricoid cartilage. 2D doppler +/- exploratory surgery
anterior cord vs central cord syndrome - CORRECT ANSWER-
anterior cord syndrome (burst fracture of vertebral bodies ->
spinothalamic and motor tracts) Loss of motor function and loss
of pain and temperature sensation on both sides distal to injury.
DCML intact (vibration and pressure) .
central cord syndrome (rear end collision -> forced
hyperextension of neck) - paralysis and burning pain in the
upper extremities with preservation of most function in lower
exgtremities
, pulmonary contusion - Dx and Tx - CORRECT ANSWER-
deteriorating blood gases, white out of the lung - Tx fluid
restriction and diuretics , b/L chest tubes if ribs fractured.
myocardial contusion - CORRECT ANSWER-EKG will detect it;
troponins study ; management is prevention of arrythmias.
traumatic rupture of the diaphragm - CORRECT ANSWER-
bowel in the chest always on the left (liver is protective). Any
suspicion calls for laparoscopy. surgery is via the abdominal
cavity.
traumatic rupture of the trachea or major bronchus - CORRECT
ANSWER-subcutaneous emphysema in upper chest and lower
neck or large air leak from a chest tube. Chest X-ray confirms
the presence of air in the tissues, and fiberoptic bronchoscopy
identifies the lesion and allows for intubation to secure an
airway. surgical repair follows.
traumatic rupture of the aorta - CORRECT ANSWER-the worst
hidden injury. occurs at the section of the aorta where the
ligamentum arteriosum attaches and occurs due to high
decelleration injury. Death occurs by adventitial rupture of
extravasated hematoma.
air embolism - CORRECT ANSWER-presentation is a chest
trauma patient who is intubated and on respirator or subclavian
vein is opened to the air i.e. central line, supraclavicular lymph
node biopsy. managment is cardiac massage in Left lateral
decubitus. Trendelenburg position while performing procedures
is a good preventitive measure.
fat embolism - CORRECT ANSWER-patient with multiple
trauma - several long bone fractures developing petechial
rashes in axillae and neck ; fever, tachycardia, low platelet
count who shows a full-blown pic of respiratory distress,
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