3/14

A young man is involved in a motor vehicle collision. In the ED, his GCS score is 7. His blood pressure is 115/70 mm Hg and heart rate is 85 bpm. His pupils are 3 mm, equal, and reactive to light. Neuro exam is normal. You intubate the patient and place him on a mechanical ventilator. The FAST ultrasound is negative, and there are no other obvious injuries, including a negative non contrast head CT. Which of the following is most important in management? 

 

• Hyperventilation 

• Avoid hypotension 

• Repeat Head CT 

How can one differentiate between second-degree and third-degree frostbite? 

• Redness

• Blisters 

• Redness and Blisters 

• Blanching of the skin

Why is early intubation deleterious? 

• After RSI, there is a vasodilatory response placing the hypovolemic patient at high risk for more pronounced hypotension and decreased perfusion. 

• Positive pressure ventilation decreases venous return  

• Both A and B

A patient presents with a painful finger after it was accidentally slammed in a car door. On exam, he has tenderness, swelling a bruising under his right second fingernail consistent with subungal hematoma. Which of the following is true. 

• Nail trephination if >50 % nailbed surface 

• Discharge with antibiotics 

• Emergent hand surgery consultation 

• IV antibiotics and CT scan 

A patient presents after her cat bit her thigh. On exam, there is a puncture wound to her thigh without surrounding erythema or drainage. In addition to thorough irrigation, what is the best next step in management? 

• Update tetanus vaccination 

• Update tetanus vaccination and obtain XR thigh 

• Update tetanus vaccination, obtain XR thigh and prescribed augmentin 

• Update tetanus vaccination, obtain XR thigh and prescribed cephalexin