Answers

1 B. Such a patient usually has bleeding, CSF rhinorrhoea

and drooling saliva. Lateral position

allows easy outward flow of these thus pre-,

venting aspiration in unconscious patient and

blocking of respiratory tract in other patients.

Prone position though equally effective poses

problem in respiration and abdominal pressure.

In A, D chances of aspiration, and respiratory

blockage are high.

2 A. No movement of neck, spinal area should be

made, rather such patient should be carried with

a neck collar. In all other conditions patient

should be carried in lateral position.

3 D. In all these conditions tongue falls back due to

loss of its attachment via genioglossus muscle in

(B) due to loss of control of the tongue, causing

respiratory embarrassment.

4 B. With all other manoeuvres bleeding would

continue and even increase.

5 D. It is used to mark the level of unconsciousness

by means of ascertaining A,B,C.

6 D. Pupils have a direct relation with physiological

status of the brain.

In concussion: Pupils are dilated and equal in

size, react to light.

In subdural haematoma: Pupils first constrict

and then dilate and become nonreacting to light.

As patient progresses pupils attain normal size

and normal reaction.

7 C. Though all the methods can be used but easy,

quick tentative result can be achieved by (C).

8 C. Most important complication with this method,

if pack left for longer duration of time.

9 B. The IX, X, XI nerve leaves jugular foramen in

middle cranial fossa. IX, X nerve supply

pharynx, palate. Any trauma, haematoma in this

area can cause compression of these nerves.

10 C. The choice of crystalloid is based on the solution

having high osmotic value. This maintains fluid

in the vascular compartment. (Since after such

trauma hypovolumic shock may be precipitated).

Normal saline, 5% dextrose, 10%, dextrose all

are isotonic and fluid moves away in cells again

making vascular compartment hypovolumic

resulting in hypovolumic shock.

11 D.

12 A. If more than 24 hours-delayed primary closure

or secondary healing should be considered. By

this time oedema and infection would have set

in and primary suturing would fail.