Damage to the lateral surface of the nose and eyelids near the inner corner leads to
eyelid contusion
+ injury of lacrimal apparatus
eyelid injury
wounds of the eyeball
orbital trauma
***
To closed brain injury does not include
brain concussion
contusions of the brain
cerebral compression
+ gunshot wounds
diffuse-axonal brain damage
***
The child, aged 12 admitted the emergency hospital. On examination: consciousness is clear, tachycardia, blood pressure 110/70 mm Hg, pale skin, lips are cyanotic, the extremities are cold. The instrumental examination: CVP is lowered to 30 mm of water column.Your preliminary diagnosis
collapse
syncope
decompensated shock phase
pulmonary edema
+ compensated shock phase
***
Select the principles of the causes elimination of this condition in a child
+bleeding stoppage, pain relief, the allergen elimination, the removal of the tensioned pneumothorax
massage of the carotid sinuses, Valsalva technique, mechanical irritation of the pharynx
spray the face with water, give to inhale ammonia
introduction of a nasogastric tube, rehydration
airway management, mechanical ventilation and chest compressions
***
Choose the best treatment for this child
+epinephrine, diphenhydramine, application of ice, dopamine
papaverine, dibazol, no-spa,hydrocortisone, poliglukine solution 20 per kg for 20 min
nitroglycerine, morphine, sodium nitroprusside, seduksen
caffeine, metazone, glucose 20-40% 2 ml per kg intravenously, atropine
Panangin, digoxin, furosemide, procainamide
***
Dislocation is
+ complete separation of the articular ends of two bones articulated with rupture of the capsule ligament
disturbance of the bone integrity
broken bones or damage to one segment of one joint
united injuries of the musculoskeletal system and other organs and anatomical structures
soft tissues and tendons injuries
***
Pharyngeal abscess - a
narrowing of the pharyngeal lumen
+ limited purulent inflammation of the paratonsilar tissue space
inflammation of the mediastinal fatty tissue
imbibitions of blood to paratonsilar space
chemical damage of the mucous membrane of the pharynx
***
There are dislocations in the carpal-metacarpal joints of the fingers 2-3-4-5, they are result of
as a result of the simultaneous action of forces in which there is a sharp adduction, inversion occurred
during a strong push at direct angle to the axis of the carpal-metacarpal
occurs during the intense pressure that is accompanied by rotation of the wrist
+ during a strong push in the middle or bottom of the palm at dorsal-flexed wrist position
during a strong push at direct angle to the axis of the carpal-metacarpal, occurs during the intense pressure that is accompanied by rotation of the wrist
***
Determine the type of fracture: a sharp turn of foot inward as a result of excessive tension of the external ligament detachment of outside of the ankle occurred
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Desto fracture
+ supination
pronation
Dupuytren's fracture typ
deformation in the form of breeches
***
"Snow blindness" is the result of
burns from UV radiation
chemical burns
orbit injuries
prolonged exposure to bright sunlit snow surface
penetration of a foreign body into the eyelid tissue
***
Reposition by the Watson-Jones method applied for
dislocation of the lumbar vertebrae
compression fracture of the lumbar vertebrae
+ compression fractures of the lower and upper chest vertebrae
flexion-rotationfracture
fracture-dislocation of the neck vertebrae
***
The symptom of "sticky heel" - the patient can not lift the leg straightened at the knee, is characteristic of
isolated fracture of the sacrum
fracture of the anterior pelvic ring
vertical fracture Malgenia type
fracture of the ischium
central dislocation of the hip
***
Acute disease process that occurs in the body after an injury is it
+ burn shock
traumatic shock
electric shock
hemorrhagic shock
***
"Apnea" - is
+ Respiratory arrest in 20 seconds
Complete respiratory arrest
The alternation depth of breath
shortness of breath
The alternation depth of breath, shortness of breath
***
The acute period of traumatic disease is accompanied by
+acute blood loss, intoxication
severe intoxication
Acute respiratory failure
the suppression of consciousness
a decrease of blood pressure
***
The hypoperfusion phase is characterized by
+ Disturbance of systematic, organ and micro vascular hemodynamic and metabolism
neurohumoral apparatus disturbance
restore blood flow to visceral organs
with natural recovery of a system of organ perfusion, microcirculation, and the main parameters of homeostasis
neurohumoral apparatus disturbance, restore blood flow to visceral organs
***
Primary Trauma shock
Develops within a few hours after injury
+Develops in the time of the injury or immediately after
Spasm of peripheral vessels
Develops from blood loss
hemodynamic disorders
***
Patient M was admitted to the hospital in 6 hours after accident. AD - 80 / 40 mmHg, decrease of urine, pulse -110-130 per minute, pulse filling is weak, the moderate state. Lost 1.5 liters of blood. Determine the severity of traumatic shock
I
+ II
III
IV
V
***
By clinical picture the following phases exist
erectile and torpedophase
+2 phases: primary and secondary
3 phases: primary, secondary and erectile
2 phases: the initial stabilization phase
2 phases: compensation and stabilization
***
Patient M is inhibited, indifferent to the environment, ground -skin tone, heart rate is 130-140 per minute. Systolic blood pressure 60 mm Hg diastolic is not defined, anuria. Determine the degrees of traumatic shock, and assign the treatment
stage I, droperidol
stage II, furasemide
stage III, glucocorticoids
+ stage IV, anticholinergics
stage V anticholinergics
***
Acute pathological process that occurs in the body after an injury
syncope
collapse
traumatic shock
+ anaphylactic shock
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syncope, collapse
***
System's inability to provide adequate hemodynamic oxygen delivery to tissues is the basis of
Infectious-toxic shock
+traumatic shock
anaphylactic shock
painful shock
anaphylactic shock, painful shock
***
Multipleinjuries
Define multiple mechanical trauma (injury)
Damage to a single anatomical and functional segments, one internal organ, vessel or nerve within the same anatomical region
Simultaneous injury of two or more organs in the different cavities or internal organ damage in combination with a broken segment of the musculoskeletal system
Damage resulting from the impact of various traumatic factors
+ Simultaneous injury of two or more organs within a cavity or damage to different segments of the musculoskeletal system
Damage resulting from exposure to chemical substances
***
What are typical complication for multiple trauma
Pneumothorax
Hemathorax
Acute heart failure
Acute kidney failure
+ Fat embolism
***
The duration of the catabolic phase
10 min - 24 h
24 h - 48 h
+About 1 week
About 1 month
From 1 month to 3 months
***
Victims of the third group are
The victims who need to be performed emergency surgery for health reasons
The victims who need to be performed emergency surgery, but no evidence of vital signs impairement
+ Victims of multiple open and closed injuries of the locomotor system
Victims with multiple injuries but without any vital signs and shock disturbances
Affected with an isolated injury without evidence vital and signs of shock
***
What mechanism underlies the motor vehicle accident tow truck to fire or gas explosion in a mine
One-stage mechanism
+ Sequential mechanism
Combined mechanism
The direct mechanism
Indirect mechanism
***
What are common causes of multiple trauma
Katatrauma
+ Traffic injuries
Solid objects
Lightning strikes
Burns
***
What syndrome is the leading in multiple trauma
Menengial syndrome
Hemorrhagic syndrome
+. Syndrome of the relative weights
Pain syndrome
The dislocation syndrome
***
What is the basic principle of operation on osteosynthesis in intra-articular injuries
"Bottom-up": the forearm-shoulder, ankle-thigh
+"Top-down": the shoulder-the forearm, thigh and ankle
"Right - left."
"Left - right."
"In the side - the side."
***
The following manipulations carried out on what phase: temporary immobilization and anesthesia
TheCatabolic phase
The anabolic phase
The phase of vital functions instability (shock)
+ The relative phase of vital functions stabilization
The phase of sustainable adaptation
***
There are specific contraindications in which phase the surgery cant be performed
+ The catabolic phase
The anabolic phase
The phase of vital functions instability (shock)
The relative phase of vital functions stabilization
The phase of sustainable adaptation
***
In what case a sequential mechanism of injury occurs
Hit the knee of the front panel
Breast stroke on the steering wheel
Fall from the height
+ Vehicles hitting a pedestrian
Accident tow truck to fire or gas explosion in a mine
***
Asphyxia and drown
What means the term Asphyxia
+condition, which arise in consequence of sharp insufficiency of oxygen in organism
Allergic diseases, which characterized by attack of asphyxia, caused by disorder of bronchial tube passability (spasm of small bronchial tube, edema of bronchial tube mucosa and accumulation of fluid in bronchi)
Unpleasant sensory and emotional feeling, connecting with truth or potential damage of tissue
Basic sign, signalized about arising of heart insufficiency
Using the oxygen with treatment purpose
***
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How many types of drown are present
2
3
4
5
***
What is the one of compliance of drown
tuberculosis
arterial hypertension
+ pneumonia
chicken-pox
acute renal insufficiency
***
What means the term drown
+ death or terminal condition (coma), arising as result of water penetration (rarely other fluids) in lungs and respiratory ways
terminal stage of edema: agonizing feeling of insufficiency of air, fear of death
developed acute at respiratory way diseases
asthmatic condition which characterized with acute asphyxia attack
types of difficulty of respiration
***
What means the term white drown man
+pale skin, as patient in the water dont breath and water dont enter in lungs. Clinical death to arise from the infarct, as reflex stoppage of heart
bluish skin, vein of neck is at norm. Entering of some water in lung, clinical death to arise from the spasm of glottis
swollen of neck vein, in lung a lot of water. Reanimation is difficult
characterized by marked spasm of peripheral vessels. Edema of lungs dont occur
developed reflex of laryngspasm and aspiration of water not occur, asphyxia are developed
***
What means the term blue drown man
+bluish skin, vein of neck is at norm. Entering of some water in lung, clinical death to arise from the spasm of glottis
characterized by marked spasm of peripheral vessels. Edema of lungs dont occur
pale skin, as patient in the water dont breath and water dont enter in lungs Clinical death to arise from the infarct, as reflex stoppage of heart
characterized by the quickly development of edema with discharge of white, stabile, fluffy foam
all answers incorrect
***
What means the term syncope. Blue drown man
+swollen of neck vein, in lung a lot of water. Reanimation is difficult
characterized by the quickly development of edema with discharge of white, stabile, fluffy foam
pale skin, as patient in the water dont breath and water dont enter in lungs. Clinical death to arise from the infarct, as reflex stoppage of heart
bluish skin, vein of neck is at norm. Entering of some water in lung, clinical death to arise from the spasm of glottis
developed reflex of laryngspasm and aspiration of water not occur, asphyxia are developed.
***
What is the obturational asphyxia
asphyxia from the pressing of organs of neck- hanging, strangling by loop, strangling by hands
+asphyxia from the closing of respiratory way, e.g. drown, entering the foreign body in respiratory way, closing the respiratory opening
asphyxia from the pressing thorax and stomach by the friable and massive subjects, compression
asphyxia in consequence of diseases bronchial asthma, allergic edema of larynx and other
all answers are correct
***
What mean the term Hanging
kind of strangulation asphyxia, represented strangling by loop of neck
kind of strangulation asphyxia, which provided at pressing the organs of neck by the fingers of hand or between forearm and shoulder or between thigh and shin
kind of strangulation asphyxia, to arise as result of closing of respiratory opening by parts of body or soft subjects
kind of strangulation asphyxia, to arise as result of closing of respiratory opening by the foreign bodes, half fluid or fluid, friable, thick locating in respiratory
+kind of strangulation asphyxia, represented strangling by loop of neck, under the strength of body. Death by the fracture of cervical vertebra is occurs.
***
What mean the term mechanical asphyxia
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+Developed in consequence of stopping or limiting the entrance of air in lung (drown, edema of lung, foreign body in respiratory ways, for example vomiting mass at alcohol intoxication)
Developed as result of influence of chemical substance, oppressing the respiratory center, paralyzing respiratory muscles
Developed as result of influence of chemical substances disturbed respiratory function of blood
Developed as result of influence of respiratory
Developed as result of influence of chemical substance which paralyzed the respiratory muscles
***
What mean the term toxic asphyxia
Developed as result of influence of chemical substances disturbed respiratory function of blood
Developed in consequence of stopping or limiting the entrance of air in lung (drown, edema of lung, foreign body in respiratory ways, for example vomiting mass at alcohol intoxication)
Developed as result of influence of chemical substance which paralyzed the respiratory muscles
+Developed as result of influence of chemical substance, oppressing the respiratory center, paralyzing respiratory muscles, respiratory enzymes, disturbed respiratory function of blood
Developed as result of influence of poisoning substances with asphyxical or toxic action, insufficiency of oxygen in breathing air, at different type of diseases, connecting with oppressing the central and peripheral nerve systems
***
Which form of asphyxia is asphyxia and drown
Instantaneous
Electrical
Anaerobic
+ Mechanical
Slow
***
Which type of primary medical help to arise for drowned man
To except of victim from water
To warming a victim hart towel, wetting with spirit
To providing of psr by method of mouth to mouth
Indirect massage of the heart
+All of the above
***
what means Sheffers method
+To providing of psr at injured hands of victim
To providing of psr at injured legs of victim
Indirect massage of the heart at injured hands of victim
Indirect massage of the heart at injured legs of
All are incorrect
***
Woman pulled from water. General condition: conscious is unclear, sharp movement excitation, seizures. Skin surfaces are cyanotic. This type of sinking occurs in 5-20% of all cases. At this reflective laryngospasm develops but aspiration of water is not occurred, the asphyxia appeared. This sinking appeared more often in children and woman, also at of victim in polluted, chloride water. At this the water in big amount enters in stomach. May be development of edema of lungs, but not hemorrhagic. What type of drown this case are relate
Primary
+Asphystic
Secondary
Tertiary
2 and 4 answers
***
Victim pulled from water. At examination: sharp paleness of skin surfaces, pupils are dilated, frequent breathing. Given drown develops as a result of cardiac arrest owign hit of the victim of cold water reflex rection to water hit in respiratory ways or middle ear cavity at the damaged eardrum. For this sinking the expressed spasm of peripheral vessels characterized. Edema of lungs not appeared. To what type of drown corresponds this case and description
Primary
Asphystic
Mixed
+Secondary
1 and 3 answers
***
electrical trauma
Indicate the specific nature of the current: irritation of smooth and the striated muscles, endocrine system and nervous system - the tonic contraction of muscles causes contraction of the diaphragm, fibrillation of the heart muscle, spasm of the glottis, spasm of blood vessels
+ the biological effect
the electrochemical effect
the heating effect
the mechanical effect
luminous radiation
***
Indicate the specific nature of the current: the divergence of the ions and their concentrations change with different electrical poles the formation of coagulation necrosis at the anode, and a cathode - colliquation necrosis
biological effect
+ electrochemical effect
heating effect
mechanical effect
luminous radiation
***
Indicate the specific nature of the current, the action caused by varying electrical conductivity of biological tissues. The higher the resistance of tissues, the more heat is released. The skin has a low thermal conductivity, and therefore the true electrical burns always deep, up to the carbonization
biological effect
electrochemical effect
+ heating effect
mechanical effect
luminousradiation
***
Indicate the specific nature of the current: the rapid release of heat by passing an electric current leads to the possible affected limb and dropping the patient to the side
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biological effect
electrochemical effect
heating effect
+ mechanical effect
luminous radiation
***
Determine the extent of electrical injury: loss of consciousness, disturbance or cardiac or respiratory system (or both together)
1 degree
2 degree
+ 3degree
4 degree
degree is not defined as data are insufficient
***
Determine the extent of electrical injury: instant death
1 degree
2 degree
3 degree
+ 4 degree
degree is not defined as data are insufficient
***
Determine the extent of electrical injury: no loss of consciousness, transient twitching of the muscles
+ 1 degree
2 degree
3 degree
4 degree
degree is not defined as data are insufficient
***
Determine the extent of electrical injury
1 degree
+ 2 degree
3 degree
4 degree
degree is not defined as data are insufficient
***
On examination you should identify entry and exit points of electric current of the patient. They have a different location and size. Why you need to find the current marks
for the selection of proper treatment
to determine the area affected
it is important to classify electrical injury
detection of current marks do not have practical value in the clinic
+ it is important to determine the "current loop" (i.e. the path of the current passed through the patient body), which is divided into the upper loop (both upper limbs and body) and the lower loop (lower extremities)
***
Electrical injury is characterized by
+ the presence of cardiac disorders and burns in contact with electricity, in the absence of modern diagnostic and specialized treatment can lead to disability or death
loss of consciousness, the development of cardiac shock, anuria, the appearance of skin rash
the resulting wound channel has inlet and outlet
disorder of vital functions, two or more anatomical and functional areas damage lead to the shock state
closed or open injuries of the pelvis, combined with open or closed injuries to other parts of (one or more - the skull and the brain, chest, abdomen, pelvis, extremities)
***
A necessary condition for providing first aid in emergency electric injury
+to terminate all of the electric current by different ways (switch off, unscrew the caps)
CPR
urgent hospitalization
Analgesic therapy
burrowing the victim into the ground
***
What should be injected at respiratory depression
strophanthin
+ lobeline
adrenaline
neostigmine methylsulfate (proserine)
ascorbic acid
***
What should be injected at the cardiovascular system
+ strophanthin
lobeline
adrenaline
neostigmine methylsulfate (proserine)
ascorbicacid
***
What should be injected at the cardiac arrest
strophanthin
lobeline
+ adrenaline
neostigmine methylsulfate (proserine)
ascorbicacid
***
