Damage to the eyes, ENT, upper and lower extremities, spine, open fractures and open joint damage

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©

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

***

Травматический шок©

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©

***

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©

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 can’t 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

***

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 don’t breath and water don’t 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 don’t 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 don’t occur©

pale skin, as patient in the water don’t breath and water don’t 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 don’t breath and water don’t 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 »©

+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

***

Electrical ©

Anaerobic ©

+ Mechanical ©

Slow

***

+All of the above

***

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 попадании 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©

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©

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©

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©

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

***

1 degree©

2 degree©

3 degree©

+ 4 degree©

degree is not defined as data are insufficient

***

+ 1 degree©

2 degree©

3 degree©

4 degree©

degree is not defined as data are insufficient

***

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©

+ 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)

***

+ 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©

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) ©

***

burrowing the victim into the ground

***

strophanthin©

+ lobeline©

adrenaline©

ascorbic acid

***

lobeline©

adrenaline©

ascorbicacid
***

strophanthin©

lobeline©

+ adrenaline©

ascorbicacid

***