ATLS EXAMS QUESTIONS WITH COMPLETE
SOLUTIONS
22 year old male fall from 2m, large right pneumothorax. Chest
tube placed, connected to drainage. Control x-ray shows
pneumothorax, third x-ray reveals pneumothorax Correct
Answer Tracheobronchal injury
30-year-old woman fell down four stair landing on concrete.
Unconscious for 5 minutes after the fall, full consciousness
during 10 minute transport to hospital, GCS 15, complaint is a
slight headache, 30 minute later she is unresponsive with GCS 6
and left pupil is large. Correct Answer Epidural hematoma
A 14 year old female is brought to the ED after falling from a
horse. She is immobilized on a long spine board with a hard
collar and blocks. Cervical spine x-ray:
A. Will show cervical spine injury in more than 20% of these
patients
B. Will exclude cervical spine injury if no abnormalities are
found on the x-rays
C. Are not needed if she is awake, alert, neurologically normal,
and has no neck pain or midline tenderness
D. Should be performed before adressing potential breating or
circulatory problems
E. May show atlanto-occipital dislocation if the Powers ratio is
<1 --> 1:noraml, >1 anterior, <1 posterior Correct Answer C.
Are not needed if she is awake, alert, neurologically normal, and
has no neck pain or midline tenderness
,A 15 year old male is brought to the ED after being involved in
a motor vehicle crash. He is unconscious and was intubated at
the scene by emergency personnel. Upon arrival at the ED, the
patients oxygen saturation is 92%, HR is 96 bpm and BP is
150/85 Breath sounds are decreased on the left side of the
thorax. The next step is:
A. Immediate needle crycothyroidotomy
B. Reassess the position of the endotracheal tube
C. Chest tube insertion
D. Immediate needle thoracentesis
E. Obtain a chest x-ray Correct Answer B. Reassess the
position of the endotracheal tube
A 15 year old male present following a motorcycle crash. INitial
examinations reveals normal vital signs. There is a large bruise
over his epigastrium that extends to the left flank. He has no
other apparent injuries. A CT-scan of the abdomen demonstrate
a ruptured spleen surrounded by a large hematoma and fluid in
the pelvis. The next step in the patients management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician Correct Answer D. Surgical
consult
Hemodynamisk stabil, ingen fri luft.
A 17 year old female is brought to the ED following a 2 meter
fall onto concrete. She is unresponsive and found to have a RR
of 32, BP 90/60 and HR 68. The first step in treatment is:
A. Adminstering vasopressors
,B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock Correct Answer
D. Applying oxygen and maintaining airway
A 17-year-old helmeted motorcyclist is struck broadside by an
automobile at an intersection. He is unconscious at the scene
with a blood pressure of 140/90mmHg, heart rate of 90 beats per
minute, and respiratory rate of 22 breaths per minute. His
respirations are sonorous and deep. His GCS score is 6.
Immobilization of the entire patient may include the use of all
the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar Correct Answer A. Air splints
A 17-year-old helmeted motorcyclist loses consciousness when
he is struck broad side by an automobile at an intersection. He
arrives in the ED with a blood pressure of 140/92, pulse rate 88
beats per minute, a respiratory rate of 18 breaths per minue, and
a GCS of 7. Appropriate initial immobilization of this patient
should include a semi-rigid cervical collar and:
A. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment Correct Answer B. A long
spine board
, A 20 year old athlete is involved in a motorcycle crash. When he
arrives in the ED, he shouts that he cannot move his legs. On
physical examination, there are noe abnormalities of the chest,
abdomen or pelvis. The patient has no sensation in his legs and
cannot move them, but his arms are moving. The patients RR is
28 bpm, HR is 88bpm and BP is 80/60mmHg. He is pale and
sweaty. What is the most likely cause of this condition?
A. Neurogenic shock
B. Cardiogenic shock
C. Abdominal hemorrhage
D. Myocardial contusion
E. Hyperthermia. Correct Answer A. Neurogenic shock
A 20 year old male is brought to the hospital approximately 30
minutes after being stabbed in the chest. There is 3cm wound
just medial to the left nipple. His BP is 70/33 and HR is 140.
Neck and arm veins are distended. Breath sounds are normal.
Heart sounds are diminshed, iv access has been established and
warm crystalloid is infusing. The next most important aspect of
immediate management is:
A. CT scan of the chest
B. 12 lead ECG
C. Left tube thoracostomy
D. Begin infusion of RBCs
E. FAST exam Correct Answer E. FAST exam For å se etter
tamponade? Normale resp.lyder bilateralt taler mot
trykkpneumothorax. EKG vil ikke gi noe informasjon.
Thoracostomy ikke indisert da det ikke er mistenkt
pneumo/hemothorax. CT uaktuelt pga hemodynamisk ustabil
SOLUTIONS
22 year old male fall from 2m, large right pneumothorax. Chest
tube placed, connected to drainage. Control x-ray shows
pneumothorax, third x-ray reveals pneumothorax Correct
Answer Tracheobronchal injury
30-year-old woman fell down four stair landing on concrete.
Unconscious for 5 minutes after the fall, full consciousness
during 10 minute transport to hospital, GCS 15, complaint is a
slight headache, 30 minute later she is unresponsive with GCS 6
and left pupil is large. Correct Answer Epidural hematoma
A 14 year old female is brought to the ED after falling from a
horse. She is immobilized on a long spine board with a hard
collar and blocks. Cervical spine x-ray:
A. Will show cervical spine injury in more than 20% of these
patients
B. Will exclude cervical spine injury if no abnormalities are
found on the x-rays
C. Are not needed if she is awake, alert, neurologically normal,
and has no neck pain or midline tenderness
D. Should be performed before adressing potential breating or
circulatory problems
E. May show atlanto-occipital dislocation if the Powers ratio is
<1 --> 1:noraml, >1 anterior, <1 posterior Correct Answer C.
Are not needed if she is awake, alert, neurologically normal, and
has no neck pain or midline tenderness
,A 15 year old male is brought to the ED after being involved in
a motor vehicle crash. He is unconscious and was intubated at
the scene by emergency personnel. Upon arrival at the ED, the
patients oxygen saturation is 92%, HR is 96 bpm and BP is
150/85 Breath sounds are decreased on the left side of the
thorax. The next step is:
A. Immediate needle crycothyroidotomy
B. Reassess the position of the endotracheal tube
C. Chest tube insertion
D. Immediate needle thoracentesis
E. Obtain a chest x-ray Correct Answer B. Reassess the
position of the endotracheal tube
A 15 year old male present following a motorcycle crash. INitial
examinations reveals normal vital signs. There is a large bruise
over his epigastrium that extends to the left flank. He has no
other apparent injuries. A CT-scan of the abdomen demonstrate
a ruptured spleen surrounded by a large hematoma and fluid in
the pelvis. The next step in the patients management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician Correct Answer D. Surgical
consult
Hemodynamisk stabil, ingen fri luft.
A 17 year old female is brought to the ED following a 2 meter
fall onto concrete. She is unresponsive and found to have a RR
of 32, BP 90/60 and HR 68. The first step in treatment is:
A. Adminstering vasopressors
,B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock Correct Answer
D. Applying oxygen and maintaining airway
A 17-year-old helmeted motorcyclist is struck broadside by an
automobile at an intersection. He is unconscious at the scene
with a blood pressure of 140/90mmHg, heart rate of 90 beats per
minute, and respiratory rate of 22 breaths per minute. His
respirations are sonorous and deep. His GCS score is 6.
Immobilization of the entire patient may include the use of all
the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar Correct Answer A. Air splints
A 17-year-old helmeted motorcyclist loses consciousness when
he is struck broad side by an automobile at an intersection. He
arrives in the ED with a blood pressure of 140/92, pulse rate 88
beats per minute, a respiratory rate of 18 breaths per minue, and
a GCS of 7. Appropriate initial immobilization of this patient
should include a semi-rigid cervical collar and:
A. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment Correct Answer B. A long
spine board
, A 20 year old athlete is involved in a motorcycle crash. When he
arrives in the ED, he shouts that he cannot move his legs. On
physical examination, there are noe abnormalities of the chest,
abdomen or pelvis. The patient has no sensation in his legs and
cannot move them, but his arms are moving. The patients RR is
28 bpm, HR is 88bpm and BP is 80/60mmHg. He is pale and
sweaty. What is the most likely cause of this condition?
A. Neurogenic shock
B. Cardiogenic shock
C. Abdominal hemorrhage
D. Myocardial contusion
E. Hyperthermia. Correct Answer A. Neurogenic shock
A 20 year old male is brought to the hospital approximately 30
minutes after being stabbed in the chest. There is 3cm wound
just medial to the left nipple. His BP is 70/33 and HR is 140.
Neck and arm veins are distended. Breath sounds are normal.
Heart sounds are diminshed, iv access has been established and
warm crystalloid is infusing. The next most important aspect of
immediate management is:
A. CT scan of the chest
B. 12 lead ECG
C. Left tube thoracostomy
D. Begin infusion of RBCs
E. FAST exam Correct Answer E. FAST exam For å se etter
tamponade? Normale resp.lyder bilateralt taler mot
trykkpneumothorax. EKG vil ikke gi noe informasjon.
Thoracostomy ikke indisert da det ikke er mistenkt
pneumo/hemothorax. CT uaktuelt pga hemodynamisk ustabil
