37-year-old man is struck on the side of the head but is conscious and talkative after the injury. No evidence of skull fracture. Several days later, he becomes increasingly lethargic, somewhat confused, and unable to mo
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37-year-old man is struck on the side of the head but is conscious and talkative after the injury. No evidence of skull fracture. Several days later, he becomes increasingly lethargic, somewhat confused, and unable to move his right side. Which type of event has most likely occurred?
A. Subdural hematoma
B. Epidural hematoma
C. Carotid dissection
D. Brain contusion - Answer>>> A. Subdural hematoma
A patient is hit by a car and has severe injuries to his extremities. He is immediately brought to the emergency room by EMS. Evaluation reveals that he has multiple organ injuries. He has an open, gaping wound which measures 2 x 2 centimeters, just below the right knee. The leg appears dislocated and ecchymotic. However, pulses are present in the distal extremity. He does not complain of any paresthesias. X-ray reveals that there is a fracture of the tibia. The trauma team is called. As their arrival is awaited, which of the following should NOT be done to help manage this patient?
A. Obtain culture and close wound using a sterile technique
B. Don't reduce the dislocation
C. Give tetanus toxoid/booster shot
D. Give antibiotics - Answer>>> A. Obtain culture and close wound using a sterile technique
A young woman sustains a severe head injury as the result of a motor vehicle crash. In the emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is intubated and mechanically ventilated. Her pupils are 3 mm in size and equally reactive to light. There is no other apparent injury. The most important principle to follow in the early management of her head injury is to:
A. avoid hypotension
B. administer an osmotic diuretic
C. aggressively treat systemic hypertension
D. reduce metabolic requirements of the brain
E. distinguish between intracranial hematoma and cerebral edema - Answer>>> A. avoid hypotension
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