What is the most frequently injured organ system in childhood motor vehicle accidents?

1.   ?    Extremities
2.   ?    Head and neck
3.   ?    Abdomen and pelvis
4.   ?    Chest

What organ is injured (order of frequency) in children with blunt trauma?

1.   ?    liver--spleen--kidney--pancreas--bladder
2.   ?    spleen--kidney--liver--pancreas--bladder
3.   ?    spleen--liver--kidney--pancreas--bladder

What is NOT part of a positive peritoneal lavage?

1.   ?    Bile
2.   ?    RBC more than 100,000
3.   ?    WBC more than 500
4.   ?    Alkaline phosphatase

What is the risk of postsplenectomy sepsis in trauma patients?

1.   ?    0.5 to 2.0%
2.   ?    3 - 5 %
3.   ?    5 - 10 %

Which is NOT a method by which the spleen regulates immunity?

1.   ?    Filter for encapsulated bacteria and others
2.   ?    Produces interleukins
3.   ?    Producer of IgG
4.   ?    Opsonization

What immune problems are NOT associated with a loss of the spleen?

1.   ?    Poor clearance of neutrophils with bacteria
2.   ?    Ineffective bacterial opsonization
3.   ?    Impaired neutrophil bacterial phagocytosis
4.   ?    Ineffective killer T-cell function

How much of the spleen is needed for adequate immune function?

1.   ?    25%
2.   ?    30 - 50%
3.   ?    50 - 60%
4.   ?    At least 70%

What immunizations is NOT given after splenectomy?

1.   ?    Klebsiella
2.   ?    Neisseria
3.   ?    Pneumococcal
4.   ?    Hemophilus

What is NOT a treatment of post traumatic splenic pseudocyst?

1.   ?    Splenectomy
2.   ?    Segmental resection of the spleen
3.   ?    Segmental embolization
4.   ?    Partial excision of cyst wall

What is a rough estimate of the incidence of complications after non operative management of liver injury?

1.   ?    Less than 5%
2.   ?    15%
3.   ?    25%
4.   ?    50%

T or F: A liver shunt is clearly better than primary repair with total vascular isolation for a severe liver or retrohepatic injury?

1.   ?    True
2.   ?    False

What is the most sensitive test for intestinal injury in a child?

1.   ?    CT with IV and oral contrast
2.   ?    MRI
3.   ?    Ultrasound (FAST exam)
4.   ?    DPLavage

T or F: Retroperitoneal air seen on a CT scan often is secondary to dissection from barotrauma from mechanical ventilation?

1.   ?    True
2.   ?    False

Which is NOT a part of duodenal diverticularization?

1.   ?    Distal gastrectomy
2.   ?    Internal purse string suture of the pylorus
3.   ?    Catheter drainage of the distal duodenal stump
4.   ?    Gastrojejunostomy

Which is NOT part of the treatment of rectal injury?

1.   ?    Colostomy
2.   ?    Presacral drainage
3.   ?    Antibiotic irrigation from mucous fistula

T or F: Primary repair of bile duct injury is almost never indicated in children.

1.   ?    True
2.   ?    False

What is the most successful way to control venous bleeding from a pelvic fracture?

1.   ?    Immediate embolization
2.   ?    Surgical control of the internal ilaic veins
3.   ?    Pelvic packing
4.   ?    External fixation and immobilization

T or F: renal injury with urinary extravasation requires exploration?

1.   ?    True
2.   ?    False

Which technique is NOT helpful in the intraoperative identification of a ureteral injury?

1.   ?    IVP 10 minutes after 2 ml / kg IV contrast
2.   ?    5 ml of Indigo carmine dye IV
3.   ?    Bladder irrigation with methylene blue
4.   ?    Retroperitoneal exploration

Which is usually initially treated nonoperatively

1.   ?    Extraperitoneal bladder injury
2.   ?    Penetrating but small bladder injury
3.   ?    Intraperitoneal bladder injury
4.   ?    Ureteral injury

In male urethral injury, hematoma will extend over the scrotum, perineum, and lower abdomen if it is in what fascia?

1.   ?    Colle's
2.   ?    Buck's
3.   ?    Denonvillier's
4.   ?    Scarpa's

Pelvic fractures most commonly have what kind of urethral injury?

1.   ?    Posterior
2.   ?    Anterior
3.   ?    Middle

Who is more likely to undergo primary urethral repair - girls or boys?

1.   ?    Girls
2.   ?    Boys