Pediatric Trauma Quiz

Kenneth T. Kwon, MD

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  1. A 10-year-old girl develops abdominal pain and bilious vomiting several days after injuring herself over the handlebars of her bicycle. The MOST likely diagnosis is:
  2. Your answer:
    duodenal hematoma
    pancreatic contusion
    liver laceration
    diaphragmatic injury with eventration of bowel
    gastric perforation


  3. Retinal hemorrhages can be seen in all of the following EXCEPT:
  4. Your answer:
    resuscitation/CPR
    shaken baby syndrome
    vaginally-delivered newborns
    low-speed traffic collisions
    coagulopathy/sepsis


  5. A 10-year-old trauma victim presents unconscious and hypotensive. Multiple attempts at peripheral IV access are unsuccessful. The next access of choice is:
  6. Your answer:
    internal jugular vein
    saphenous vein cutdown
    femoral vein
    external jugular vein
    intraosseous line


  7. Some states have instituted mandatory helmet laws for children for the following devices:
  8. Your answer:
    bicycle
    skateboard
    in-line skates
    scooter
    all of the above


  9. A 5-year-old boy presents with elbow pain following a fall on his outstretched arm. Elbow xrays reveal small anterior and posterior fat pads but no obvious cortical break of bone. The presumptive diagnosis is:
  10. Your answer:
    occult radial head fracture
    lateral epicondyle fracture
    elbow sprain
    nursemaid’s elbow
    nondisplaced supracondylar fracture


  11. The most commonly injured abdominal organ in pediatric blunt trauma is:
  12. Your answer:
    liver
    kidney
    spleen
    small bowel
    pancreas


  13. All of the following are appropriate medications prior to intubating an unresponsive normotensive 5- year-old trauma victim with obvious head trauma EXCEPT:
  14. Your answer:
    ketamine
    lidocaine
    etomidate
    thiopental
    fentanyl


  15. A 10-month-old is struck by a car while in his mother’s arms. On arrival, the infant is moving all his extremities spontaneously, opens eyes to pain only, and is screaming inconsolably. His Glasgow Coma Scale (GCS) score is:
  16. Your answer:
    14
    10
    15
    8
    12


  17. The most common cause of death in children under 14 years of age is:
  18. Your answer:
    suicide
    meningitis
    unintentional trauma
    cancer
    child abuse


  19. At what minimum level of microscopic hematuria should radiographic evaluation be initiated in suspected genitourinary trauma in children?
  20. Your answer:
    100 RBC/hpf
    50 RBC/hpf
    500 RBC/hpf
    1,000 RBC/hpf
    20 RBC/hpf


  21. Which of the following is TRUE concerning traumatic thoracic injuries in children?
  22. Your answer:
    thoracic injuries are usually not associated with other organ injuries
    pulmonary contusion is rarely seen without an associated rib fracture
    diaphragmatic injuries can be reliably diagnosed with chest CT
    tension pneumothorax more of a concern due to increased mediastinal mobility compared
    rib fractures are more common than in adults


  23. A hypotensive pediatric trauma victim with suspected abdominal injury is given 20cc/kg of normal saline with no change in blood pressure. The most appropriate next step in management is:
  24. Your answer:
    operative exploration
    MAST trousers
    another 20 cc/kg of normal saline
    PRBC transfusion
    5% albumin infusion


  25. All of the following concerning the pediatric cervical spine is true EXCEPT:
  26. Your answer:
    mild subluxation of C2 on C3 anteriorly can be a normal variant
    interspinous ligaments are more flexible than adults
    the pre-dens space can be larger than adults
    most fractures occur in the lower cervical spine
    facet joints are flatter than adults


  27. Which is the following is TRUE concerning submersion injuries?
  28. Your answer:
    prophylactic antibiotics are recommended
    most submersion events in America occur in natural bodies of water
    alcohol use is associated with submersion injuries in 50% of cases in adolescents and adults
    electrolyte abnormalities are commonly seen following ocean submersion events
    Hemlich maneuver is recommended as part of standard initial management


    Courtesy : Department of Pediatrics University of Hawaii John A. Burns School of Medicine

  29. What is the name of this type of fracture?
  30. Your answer:
    Smith
    Colles
    Monteggia
    Galeazzi
    Ghazala



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