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Emergency Med - Head and Neck Trauma

Total questions: 41

Worksheet time: 23mins

Name
Class
Date
1.

Upon primary survey of a traumatic head injury, which of the following would indicate endotracheal intubation?

a)

loss of gag reflex

b)

GCS < 8

c)

loss of consciousness

d)

incontinence

2.

Blunt force to the chest is a cervical spine injury until proven otherwise.

a)

True

b)

False

3.

Which of the following would help indicate that one's airway is NOT patent?

a)

crepitus

b)

flail chest

c)

tracheal deviation

d)

breath sounds

4.

What is the main concern when evaluating circulation on your primary survey?

a)

Cyanosis

b)

HoTN

c)

HTN

d)

Syncope

5.

Which of the following is an easily reversible cause of altered mental status?

a)

hypoglycemia

b)

hypoxemia

c)

overdose

d)

hypophosphatemia

6.

_______ posture results from damage to the upper brain stem. In this posture, the arms are adducted and extended, with wrists pronated and fingers flexed. Legs are stiffly extended with plantar flexion of the feet.

a)

Decortisone

b)

Decerebrate

c)

Decorticate

d)

Decelerate

7.

A pt should be completely undressed and ENTIRE body should be examined upon primary survey

a)

True

b)

False

8.

Which of the following would concern you for possible brain herniation?

a)

hypertension

b)

hypotension

c)

bradycardia

d)

respiratory depression

9.

Head lacerations can be closed up to _____ hours after initial injury

a)

8

b)

12

c)

24

d)

48

10.

Lacerations to the _______ should be repaired with absorbable sutures to prevent a subgleal hematoma and subsequent infxn

a)

Loose connective tissue

b)

Galea Aponeurotica

c)

Skin

d)

Periosteum

11.

When should you strongly consider a CT to evaluate a more serious intracranial injury?

a)

Scalp Hematoma

b)

Scalp laceration

c)

Scalp abrasion

12.

Which of the following would indicate a fracture at the base/floor of the skull

a)

Battle sign

b)

Raccoon eyes

c)

CSF leak

d)

hemotypanum

13.

Clear drainage of the ears and nose that is exacerbated by Valsalva should concern you for what?

a)

Risk of Meningitis

b)

CSF leak

c)

Otitis Media

d)

TM rupture

14.

Basillar skull fractures can be missed on CT, so if clinical signs, consult neurosurgery and consider sending home

a)

True

b)

False

15.

A pt presents with a history of initial brief LOC that progressed to a transient "lucid interval". Upon CT of the head you find a bioconvex shaped collection of blood between the dura mater and bones of skull, what is the most likely diagnosis?

a)

Epidural hematoma

b)

Subdural hematoma

c)

Subarachnoid hematoma

16.

What is the most likely source of bleeding for an elderly, alcohlic pt presenting with a crescent shaped, bioconcave bleed between the dura mater and arachnoid mater?

a)

Veins

b)

Arteries

c)

Aneurysm

17.

A pt presents to the ED with a chief complaint severe headache. She has a history of vomiting, vision changes and loss of consciousness since the onset of headache. She reports that this is the worst headache of her life that came on like a thunder clap. What would you suspect to find on CT of this female's head?

a)

blood between her eye balls

b)

blood between arachnoid and pia mater

c)

blood between arachnoid and dura mater

d)

blood between skull and dura mater

18.

A concussion is a _______ mild traumatic brain injury with temporary loss of brain function.

a)

irreversible

b)

reversible

19.

Multiple concussions over a lifetime can lead to an increased cognitive function.

a)

True

b)

False

20.

This is the diagnosis given to a pt that have persistent concussion sx despite adequate rest period.

a)

Concussive cognitive impairment

b)

Postconcussion syndrome

c)

Epidural hematoma

d)

Persistent concussion defect

21.

What is the name of the guideline recommendations for when to CT pediatric head trauma?

a)

EMTALA

b)

PECARN

c)

PCOM

d)

PCOS

22.

What should you be concerned of that can cause esophageal or airway injury upon blunt trauma to the neck?

a)

pneumothorax

b)

Pneumomediastinum

c)

Pericardial effusion

d)

Pleural effusion

23.

Any Neck Injury to ______ should be explored by a SURGEON.

a)

Sternocleidomastoid

b)

Platysma

c)

Platypus

d)

Platelet rich plasma

24.

A pt who had recent neck trauma presents with hoarseness, stridor, painful phonation and pneumothorax. What is the best option to identify the underlying cause?

a)

CT chest

b)

Bronchoscopy

c)

Esophagoscopy

d)

CXR

25.

You receive a pt with CC of Neck pain by MVA. CT results show an intimal flap of internal carotid. Which of the following steps should you consider?

a)

Consult Cardiothoracic Surgery

b)

Consult Trauma Surgery

c)

Consult General Surgery

d)

Consult Neurosurgery

26.

_______ is most common form of injury to the face.

a)

Blunt Trauma

b)

Penetration Trauma

c)

Emotional Trauma

d)

Childhood Trauma

27.

What should you be concerned of when dealing with a Parotid injury?

a)

Carotid impingement

b)

Laceration of Stensen Duct

c)

Fracture of the mandible

d)

Acquired hypothyroidism

28.

What Ophthalmologic Emergency should you be concerned of in a pt presenting with proptosis, decreased extraocular movements, elevated IOP and vision changes?

a)

Corneal abrasion

b)

Orbital compartment syndrome

c)

Ruptured Globe

d)

Glaucoma

29.

A pt complains of light sensitivity and 8/10 eye pain. Pt is unable to keep eye open and complains of severe pain upon blinking. Which of the following would be the best next step in managing this pt?

a)

Instill 1 drop of artificial tears for relief

b)

Instill fluorescein and use Wood's lamp to observe

c)

Forcefully Blow in the pt's eye

d)

Instill 3 drops of Ofloxacin

30.

What should you suspect upon visualizing this in a pt with no ocular complaints, and how should you treat the pt?

a)

Subconjunctival Hemorrhage

b)

Orbital Blowout Fracture

c)

Send home, will resolve on its own

d)

Send to Ophtho, will need surgery

31.

What should you be concerned of in a pt in the ED after a baseball hit his face experiencing double vision with inability to look upward along with decreased EOMs?

a)

Glaucoma

b)

Orbital Floor Blowout Fracture

c)

Orbital compartment syndrome

d)

Subconjunctival Hemorrhage

32.

What should you do for a pt who's TM is ruptured upon your otoscopic exam due to getting slapped by his little sister?

a)

Rx Amox/Clav PO

b)

Send home, will resolve on its own

c)

Rx Ofloxacin otic drops

d)

Send to Ophthalmology

33.

A wrestler comes into the ER complaining of ear pain. Upon exam you note that there is swelling between the perichondrium and auricular cartilage. What is the next best step in managing this pt?

a)

Tell him to rub some dirt in it

b)

Drain fluid

c)

Slap it

d)

start abx

34.

What classification would be given to a frx that includes the maxilla and bony nasal skeleton?

a)

LeFort I

b)

LeFort II

c)

LeFort III

35.

Which of the following could be treated with analgesics and sent home with a follow up appointment?

a)

LeFort I

b)

LeFort II

c)

LeFort III

36.

A pt comes in to the ED after being punched in the face by his dog. You suspect a nasal fracture. What should you inspect for to prevent necrosis and saddle nose deformity?

a)

septal herniation

b)

Septal hematoma

c)

epidural hematoma

d)

septal deviation

37.

Which of the following is is the most appropriate first step in caring for a pt presenting with an ear laceration?

a)

Local infiltration of lidocaine without epinephrine

b)

check for signs of AMS in basilar skull frx

c)

Irrigation of wound with normal saline

d)

Local infiltration of lidocaine with epinephrine

38.

A 17 yo high school football star comes into office with neck pain. He reports it started after being tackled and was followed by tingling in both arms. What is the next best step in management?

a)

Neurosurgical referral

b)

Neck Slap

c)

C spine immobilization

d)

Analgesia and observation

39.

Displacement of tooth out of socket is known as what?

a)

tooth decay

b)

tooth subluxation

c)

tooth dislocation

d)

tooth avulsion

40.

The most common tooth fracture involving the enamel and yellow dentin is considered what type of fracture?

a)

Ellis Grey

b)

Ellis II

c)

Elvis I

d)

Ellis III

41.

A 13 yo was hit in the right eye with a billiard ball. The area is ecchymotic and swollen. His pain level is a 6/10. Which of the following exam findings is most supportive of the likely diagnosis?

a)

subcutaneous emphysema

b)

Restricted ROM

c)

Proptosis

d)

loss of accomodation