Briefly describe the definition and classification of trauma.

Reference answer

Trauma refers to the continuous destruction and dysfunction of tissues caused by mechanical injury factors acting on the body.

The classification of trauma mainly includes the following four categories:

① According to the injury factors, it can be divided into sharp injury, blunt injury, cutting injury, firearm injury and blast injury;

② According to the injured site, it can be divided into brain injury, chest injury, abdominal injury and limb injury;

③ Classification according to skin integrity after injury: those without skin injury are closed injuries, such as contusion, sprain, blast injury and crush injury. Skin injuries are open injuries, such as abrasions, cuts, lacerations, stab wounds, avulsion injuries, etc.

④ According to the severity of the injury, it is generally divided into light, medium and heavy injuries.

1) Minor injuries are mainly local soft tissue injuries, temporarily losing the ability to work, but still working without life-threatening, or only requiring minor surgery.

2) Moderate injury is mainly a large area of soft tissue injury, which loses the ability to work and live, and requires surgery, but it is generally not life-threatening.

3) A serious injury refers to a person who is life-threatening or severely disabled after being cured.

The second question:

Briefly describe the differential diagnosis of hypotonic, isotonic and hypertonic dehydration.

Reference answer

Dehydration refers to a group of clinical symptoms caused by the decrease of extracellular fluid. According to the change of blood sodium or osmotic pressure, dehydration can be divided into hypotonic dehydration, hypertonic dehydration and isotonic dehydration. The differentiation of hypotonic, isotonic and hypertonic dehydration can be mainly carried out from four aspects: component loss, typical symptoms, clinical manifestations and laboratory examination.

1. Component loss: low osmotic sodium loss >: water loss, isotonic isobaric sodium loss, water loss, high osmotic water loss >: sodium loss.

2. Typical symptoms: chronic intestinal obstruction is mainly hypotonic, intestinal fistula is mainly isotonic, and esophageal cancer obstruction is mainly hypertonic.

3. Clinical manifestations: hypotonic symptoms are poor consciousness without thirst, isotonic symptoms are dry tongue without thirst, and hypertonic symptoms are thirst.

4. Laboratory examination: hypotonic sodium ion:150mmol/l. 。

The third question:

Clinical manifestations of hypothyroidism.

Reference answer

Hypothyroidism is a disease caused by decreased synthesis and secretion of thyroid hormone or insufficient physiological function. Its clinical manifestations are mainly described by symptoms and signs.

1. Symptoms: The main manifestations are decreased metabolic rate and decreased sympathetic nerve excitability. Typical patients show chills, fatigue, swelling of hands and feet, lethargy, memory loss, hypohidrosis, joint pain, weight gain, constipation, menstrual disorder or menorrhagia in women, infertility and so on.

2. Signs:

① General patients may have dull expression, slow response, hoarseness, hearing impairment, pallor, edema of face and/or eyelids, thick lips and big tongue, frequent tooth marks, dry and rough skin, desquamation, low skin temperature and edema, ginger skin on hands and feet, sparse and dry hair, prolonged Achilles tendon reflex time and slow pulse rate.

(2) A few cases have myxedema in front of tibia.

③ Pericardial effusion and heart failure may occur when the heart is involved.

④ Myxoedema coma may occur in severe cases.

The fourth question:

What is a hernia? What are the pathogenic factors of external abdominal hernia?

Reference answer

Any organ or tissue that leaves its original position and enters another part through normal or abnormal weaknesses, defects and pores of the human body is called hernia. Hernia mostly occurs in the abdomen, and external hernia is more common than external hernia.

Abdominal external hernia is one of the most common diseases in surgery, which is caused by the internal organs or tissues protruding from the body surface through the weak points or defects of abdominal wall or pelvic wall.

The main pathogenic factors are the decrease of abdominal wall strength and the increase of intra-abdominal pressure:

(1) The common factors that reduce the strength of abdominal wall are: ① Some tissues pass through abdominal wall, such as spermatic cord or ligamentum teres uteri passing through inguinal canal and femoral artery passing through femoral canal; ② The white line of abdomen can also become the weak point of abdominal wall due to hypoplasia; ③ Poor healing of surgical incision, abdominal trauma and infection, abdominal nerve injury, muscle atrophy caused by old age, chronic diseases and obesity are also the reasons for the decrease of abdominal wall strength.

(2) Increased intra-abdominal pressure: Chronic cough, chronic constipation, dysuria, ascites, pregnancy, weight lifting and frequent crying of infants are the common causes of increased intra-abdominal pressure. Although normal people sometimes have increased intra-abdominal pressure, if the abdominal wall is intact and maintains a certain strength, hernia will not occur.