A&P
Name 3 types of bones + their structure/function
Long = tubular; strength, structure, mobility
Short = cuboidal; support, stability
Flat = protection, broad surface attachment
Irregular = oddly shaped; various functions
Sesamoid = develop in tendons where they cross long bones; protect tendons from wear and tear
What 3 neurotransmitters does cocaine increase levels of in the synaptic cleft?
Dopamine, norepinephrine, serotonin
What type of metabolism creates high levels of lactate in the body and what acid base disorder can high levels cause?
Anaerobic metabolism
Acidosis
First line DVT prophylaxis for trauma patients + what factor it targets
LMWH, Xa
A term that describes trauma that can impact partners, families and be passed on to children, and even children’s children.
Intergenerational trauma
Name one way the intrinsic pathway of the coagulation cascade can be initiated
exposure to collagen (/any negative protein) OR thrombin can activate factor XI (positive feedback mechanism)
As hypothermia sets in, the body tries to preserve/produce heat through compensatory mechanisms. Name 2.
Examples: peripheral vasoconstriction, shivering thermogenesis, increased sympathetic activity (tachycardia, tachypnea), increased muscle tone, brown fat thermogenesis
PT/INR measures the _____ clotting pathway and monitors ____ therapy, while aPTT measures the _____ clotting pathway and monitors ____ therapy.
PT/INR = extrinsic/warfarin
aPTT = intrinsic/heparin
Name 3 rewarming methods used in hypothermia
Passive (blankets, warm room), forced air systems, bair hugger, warmed IV fluids, peritoneal/gastic lavage, extracorporeal warming (hemodialysis, cardiopulmonary, etc.), etc.
WHY and for HOW LONG does a form 1 apply?
Risk of serious harm to self or others
72 hours for psychiatric assessment
What are 3 differences between spongy and compact bone? (ex: percent of skeletal makeup, structure, location, arrangement, function)
100 points per difference!
Spongy ⇒ 20% of skeleton; trabecular or cancellous; deep to compact; arranged in trabecular (irregular columns); filled with red marrow in metaphysis and epiphysis
Compact ⇒ 80% of skeleton; strongest; deep to periosteum; arranged in circular osteons; protect and support
Name 2 risk factors and 2 protective factors for suicide
Answers from the clin skills guide:
Risk = previous suicide attempts!, current psychiatric disorder (bipolar, depression, schizophrenia), hopelessness, mood disorder + substance use, demographics (15-24 yo + elderly men), SLE, chronic disease, family hx of suicide, ACEs, living alone, access to firearms, etc.
Protective = marital status, parenthood, social networks, patient relationship with clinician, religious beliefs, cognition, self esteem, ambivalence, MSE reality testing intact
What does "angulation" mean in terms of fractures? What are the two main "types"/"categories"?
Angulation: Deviation of the fracture fragments from normal anatomical alignment, measured in degrees; the angle formed between the long axes of the proximal and distal fragments
Varus: Angulation where the apex of the deformity points away from the midline (medially)
Valgus: Angulation where the apex of the deformity points toward the midline (laterally)
In addition to prolonged immobilisation, what else about this case makes Myles high risk for a DVT? (i.e. why else would we initiate prophylaxis)
Myles: pelvic and lower extremity fractures (femur, tibia) or surgery
Other (NOT myles, just FYI): older age, blood transfusion, spinal cord injury, >3 ventilator days, venous injury, abnormal coagulation, history of thromboembolism, obesity, malignancy, GCS < 8.
When was the last federally funded residential school in Canada closed? (+/- 1 year)
1977
How does the periosteum drive fracture healing (2 reasons)?
200 for each reason!
- source of pluripotent progenitor cell (chrondrocytes/osteoblasts)
- rapid neovascularization via periosteal blood vessels
Hemorrhagic shock can be categorised by %blood loss from Class I to Class IV. What are 3 clinical, laboratory, or historical findings that separate classes?
HR, BP, RR, Pulse pressure, Urine output, mental status, capillary refill
A CIWA score between 9 and 15* prompts management with what?
*different sources say anywhere between 8-20
Lactated Ringer's (LR) and 0.9% saline (NS) are both isotonic fluids. Name 2 differences between them.
LR = balanced, Na, Cl, K, Ca, lactate, less prone to acidosis, lower renal impact, contraindicated in liver disease/hyperK/metabolic alkalosis
NA = unbalanced, Na, Cl, risk of hyperchloremic NAGMA, used more for TBI, contraindicated in heart/kidney disease, fluid overload, hyperchloremia, cheaper
List 3 specific ceremonies, practices, or traditions which may offer Indigenous people a sense of cultural connection throughout healing (there are many examples beyond the ones I've listed - other answers are acceptable as long as rationale/resources are provided)
Examples include: sweat lodge ceremonies, smudging ceremonies, music (drumming/singing), talking/sharing circles, traditional teachings (i.e. tribal histories), story telling, art creation, fasting, incorporating natural foods/medicines, elder guidance/mentorship, land base activities, involving their familes/community in treatment, social activities, etc. etc. etc.
Main Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC4158387/
The intrinsic and extrinsic pathways of the coagulation cascade converge when they activate factor X to factor Xa. Explain the rest of the pathway from here to clot formation.
(will give partial points of 250 for minimal mistakes/misses)
1) Factor Xa + Factor Va + Ca2+
2) ^^^ Factor II --> Factor IIa
3) ^^^ Factor I --> Factor Ia
4) ^^^ + Ca2+ + Factor XIIIa
What is a salter harris fracture (general) and what does each of the 5 grades (I-V) mean, briefly?
Pediatric fractures which involve growth plates (physis)
Graded based on severity (I - V/SALTR):
I (S) = “straight across", through physis, shearing forces
II (A) = "above", through physis; extending into metaphysis, trauma
III (L) = "lower", through physis; extending into epiphysis/ joints, intraarticular trauma
IV (T) = "through/two", crosses all zones (metaphysis, physis, epiphysis), complex trauma
V (R) = "rammed/reduced", crushing injury to physis disrupts growth potential, axial compression
Myles' hemoglobin was normal. What are 2 reasons that hemoglobin could be elevated?
polycythemia vera, dehydration, diuretic use, chronic hypoxia (lung disease, smoking, sleep apnea, high altitudes), EPO secreting tumours, testosterone therapy, etc.
Surprise! Kahoot on ATLS Protocol...
Rules:
Team that chose this square = 2x multiplier of points below
Other Team = just the points below
Points per place
1st = 300 pts ; 2nd = 250 points ; 3rd = 200 pts ; 4th = 150 pts; 5th = 100 pts; 6th = 75 pts; 7th = 50 pts; 8th = 25 pts.
First Nations, Inuit, and Métis patients represent people from distinct populations--what is the major difference between these populations in terms of legal and governance context? How does this impact healthcare?
First Nations = registered under the federal "Indian Act" as "Status Indians"; federal health benefits
Inuit = operate under modern land claim agreements NOT the Indian Act (they do not have "Indian Status"); they do have federal Non-Insured Health Benefits (NIHB) program
Metis = NOT governed by the Indian Act and do not hold "Indian Status" (affirmed under Section 35 of the Constitution Act, 1982); some supplementary health benefits