TEST 2026
QUESTIONS
&
ANSWERS
, 6
1. The primary indication for transferring a 4. Which one of the following statements
patient to a higher level trauma center is: regarding patients with thoracic spine injuries is
TRUE?
unavailability of a surgeon or operating room Log-rolling may be destabilizing to
staff. fractures from T-12 to L-1.
multiple system injuries, including severe Adequate immobilization can be
head injury. accomplished with the scoop stretcher.
resource limitations as determined by the Spinal cord injury below T-10 usually spares
transferring doctor. bowel and bladder function.
resource limitations as determined by the Hyperflexion fractures in the upper
hospital administration. thoracic spine are inherently unstable.
widened mediastinum on chest x-ray These patients rarely present with spinal
following blunt thoracic trauma. shock in association with cord injury.
2. teen-aged bicycle rider is hit by
b y a truck 5. young man sustains a ritle wound to the mid-
traveling at a high rate of speed. In the abdomen. He is brought promptly to the
emergency department, she is actively bleeding emergency department by prehospital
from open fractures of her legs, and has personnel. His skin is cool and diaphoretic, and
abrasions on her chest and abdominal wall. Her his systolic blood pressure is 58 rnm Hg.
blood pressure is 80/50 mm Hg, heart rate is Warmed crystalloid fluids are initiated without
140 beats per minute, respiratory rate is 8 improvement in his vital signs. The next, most
breaths per minute, and GCS score is 6. appropriate step is to perform:
The first step in managing this patient is to: a celiotomy.
an abdominal CT scan.
obtain a lateral cervical spine x-ray. diagnostic laparoscopy.
insert a central venous pressure line. abdominal ultrasonography.
administer 2 liters of crystalloid solution. a diagnostic peritoneal lavage.
perform endotracheal intubation and
ventilation.
apply the PASG and inflate the leg
6. young woman sustains a severe headhe ad injury
compartments. as the result of a motor vehicular crash. In the
emergency department, her GCS score is 6. Her
blood pressure is 140/90 mm Hg and her heart
3. Contraindication to nasogastric intubation is rate is 80 beats per minute. She is intubated and
the presence of a: is being mechanically ventilated. Her pupils are
gastric perforation. 3 mm in size and equally
equall y reactive to light.
diaphragmatic rupture. There is no other apparent injury. The most
open depressed skull fracture. important principle to follow in the early
fracture of the cervical spine. management of her head injury is to:
fracture of the cribriform plate.
administer an osmotic diuretic.
prevent secondary brain injury.
, RRERERETEFWGFFDHDF
aggressively treat systemic hypertension. 9. 8-year-old girl is an unrestrained passenger
reduce metabolic requirements of the in a vehicle struck from behind. In the
brain. emergency department, her blood pressure is
distinguish between intracranial hematoma 80/60 mm Hg, heart rate is 80 beats per minute,
and cerebral edema. and respiratory rate is 16 breaths per minute.
Her GCS score is 14. She complains that her
legs feel "funny and won't move right;"
Никто
7. 22-year-old man в городе
is brought не мог точноhowever,
to the hospital сказать, когда
her spine x-rays do not show a
появилась эта библиотека. Она
after crashing his motorcycle into a telephone
fractureпросто былаA—
or dislocation. spinal cord injury in
всегда, между булочной и аптекой,
pole. He is unconscious and in profound shock.
this child: с деревянной
вывеской, которую никто не читал.
He has no open wounds or obvious fractures.
is most likely a central cord syndrome.
The cause of his shock is MOST LIKELY
Антон зашёл туда однажды от mustдождя.
be diagnosed by magnetic resonance
caused by:
Библиотекарь
a subdural hematoma.
— пожилая женщина с
imaging.
серебряными
an epidural hematoma. волосами — подняла
глаза и
can be excluded by obtaining a CT of the
сказала: lumbar«Ваша книга уже ждёт вас».
entire spine.
a transected spinal cord.
may exist in the absence of objective
«Я ничего не заказывал», — ответил он.findings on x-ray studies.
a transected cervical spinal cord.
hemorrhage into «Здесь
the chest никто ничего не заказывает»,
or abdomen.
is unlikely— сказала
because of the incomplete
она и положила на стойку потрёпанный calcificationтом
of theбез
vertebral bodies.
названия.
8. 30-year-old man is struck by a car traveling
at 56 kph (35 mph).Антон He hasоткрыл
obvious его. Наofпервой странице было
fractures 10. Immediate chest tube insertion is indicated
the left tibia nearнаписано
the knee, pain его имя.
in the На второйfor—
pelvic дата его
which of the following conditions?
area, and severeрождения.
dyspnea. His heart На rate
третьей
is 180 начиналась история егоPneumothorax
beats per minute, жизни
and his — точная,
respiratory rateсо всеми деталями, которые
is 48 Pneumomediastinum
breaths per minute помнил
with no только
breath soundsон. heard Massive hemothorax
in the left chest.Он листал
A tension в оцепенении,
pneumothorax is пока не добрался до
Diaphragmatic rupture
страницы с сегодняшним днём. Текст обрывался
relieved by immediate needle decompression Subcutaneous emphysema
and tube thoracostomy. Subsequently, his heart
на середине предложения.
rate decreases to 140 beats per minute, his
Дальше страницы были чистыми.
respiratory rate decreases to 36 breaths per 11. 18-year-old, helmeted motorcyclist is
minute, and his «Что это значит?»
blood pressure is 80/50 inm— прошептал
Hg. broughtон. by ambulance to the emergency
Warmed Ringer's «Это
lactateзначит, что конец ещё department
is administered не написан», following —a high-speed crash.
intravenously. The ответила
next priorityбиблиотекарь.
should be to: — «Большинство
Prehospital persormelлюдей report that he was thrown
боятся пустых
perform a urethrogram страниц. Но только
and cystogram. 15 metersв(50 нихfeet)есть
off his bfice. He has a
настоящая
perform external fixation of theсвобода».
pelvis.
history of hypotension prior to arrival in the
Антон
obtain abdominal andвышел из библиотеки.emergency
pelvic CT scans.
Дождь department,
прекратился. but is now awake, alert,
Он посмотрел на улицу иначе
perform arterial embolization of the pelvic
— как будто видел
and conversational. Which of the following
vessels. statements is TRUE?
её впервые, как будто она ждала, что он сделает
perform diagnostic peritoneal lavage or Cerebral perfiision is intacto
с ней что-то новое.
abdominal ultrasound. Intravascular volume status is normal.
The patient has sensitive vasomotor
reflexes.
2