ATLS EXAM REVIEW – COMPLETE QUESTIONS AND ANSWERS (GRADED A+)

REVIEWEDATLSEXAMQUESTIONSAND jt jt jt jt




ANSWERS
True or false? Although the mechanism of injury may be similar to those for the younger population, data s
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hows increased mortality with similar severity of injury in older adults. - CORRECT ANSWER-True
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In the elderly population, what is decreased physiological reserve? - CORRECT ANSWER-
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aging is characterized by impaired adaptive and homeostatic mechanisms that caused an increased suscepti
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bility to the stress of injury. Insults tolerated by the younger population can lead to devastating results in el
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derly patients. jt




Pre-existing conditions that affect morbidity and mortality include: - CORRECT ANSWER-
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cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
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What is the most common mechanism of injury in the elderly? - CORRECT ANSWER-
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Fall. Nonfatal falls are common in women and fractures are common in women who fall. Falls are the most c
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ommon cause of TBI. jt jt jt




In the elderly population, what are risk factors for falls? - CORRECT ANSWER-
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advanced age, physical impairment, history of previous fall, medication use, dementia, unsteady gait, and visua
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l, cognitive impairment
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Most of elderly traffic fatalities occur in the daytime and on weekends and typically involve other vehicles.
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Why? - CORRECT ANSWER- jt jt jt




Older people drive on more familiar roads and at lower speeds and tend to drive during the day. Older peop
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le have slower reaction time, a larger blind spot, limited cervical mobility, decreased hearing, and cognitive
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impairment.



True or False? Mortality associated with small to moderate sized burns in older adults remains high -
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CORRECT ANSWER-True
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,Spilled hot liquids on the leg, which in younger patients may re-
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epithelialize due to an adequate number of hair follicles, will result in a full thickness burn in older patients.
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- CORRECT ANSWER-this is true
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Airway-
patients may have dentures that may loosen or obstruct the airway. If dentures are not obstructing the air
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way, leave them in place for what? - CORRECT ANSWER-bag mask ventilation, as it improves mask fitting.
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When preforming rapid sequence intubation, the dose of benzos, barbiturates, and other sedatives sh
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ould be reduced to what percentage to minimize the risk of cardiovascular depression? -
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CORRECT ANSWER-20-40%
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Functional changes in cardiac system include declining function, decreased sensitivity to catecholamines,
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atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta blockers) jt jt jt jt jt jt jt jt jt jt




- CORRECT ANSWER-
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this results in lack of classic response to hypovolemia, risk for cardiac ischemia, elevated BP at baseline, and
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increased risk of dysrythmias. jt jt jt




Functional changes in pulmonary system include decreased elastic recoil, reduced residual capacity, decre
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ased gas exchange and decreased cough reflex - CORRECT ANSWER-
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thus they are at increased risk for respiratory failure, increased risk for pneumonia, and poor tolerance to ri
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b fractures
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Functional changes in renal system include loss of renal mass, decreased GFR, and decreased sensitivity to A
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DH and aldosterone - CORRECT ANSWER-
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resulting in drug dosing for renal insufficiency, decreased ability to concentrate urine, increased risk for AK
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I and urine flow may be normal with hypovolemia
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Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints and cartilage, c s
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pine degenerative changes and loss of skin elastin and subcutaneous fat - CORRECT ANSWER-
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resulting in increased risk for fractures, decreased mobility, difficulty for oral intubation, risk of skin injury, i
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ncreased risk for hypothermia, challenges in rehabiliation jt jt jt jt jt jt




Functional changes in Endocrine system include decreased production and response to thyroxin and de
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creased dehydroepiandrosterone (DHEA) - CORRECT ANSWER-
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resulting in occult hypothyroidism, relative hypercortisone states and increased risk of infection
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, True or false: Arthritis can complicate the airway and cervical spine. Patients can have multilevel degenerative c
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hanges affecting disk spaces and posterior elements associated with severe central canal stenosis, cord compre
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ssion, and myelomalacia - CORRECT ANSWER-true
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In elderly population, due to their changes in pulmonary system, placing a gauze between gums and cheek
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to achieve seal when using bag valve mask ventilation is okay. In addition, because aging causes a suppress
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ed heart rate response to hypoxia. .................. .. - CORRECT ANSWER-respiratory failure may present
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insidiously in older adults. jt jt jt




Age related changes in the cardiovascular system place the elderly trauma patient at significant risk for bein
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g inaccurately categorized as hemodynamically stable. - CORRECT ANSWER-
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Elderly patients have a fixed heart rate and fixed cardiac output, thus, their response to hypovolemia will in
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volve increasing their systemic vascular resistance. Furthermore, since older patients have HTN, an accept
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able BP may truly reflect a hypotensive state. A systolic BP of 110 is to be utilized as the threshold for identi
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fying hypotension in patients 65 and older.
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Do no equate blood pressure with shock in older patients - CORRECT ANSWER-
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BP in older patients may look normal due to the medications they are on. Use lactate and base deficit to eva
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luate for evidence of shock jt jt jt jt




what 2 factors place elderly patients at risk for intracranial hemorrhage? - CORRECT ANSWER-
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aging causes dura to become more adherent to the skull increasing risk of injury and older patients are
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on anticoagulant and antiplatelet medications.
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Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions place elderly patients as risk f
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or hypothermia and complications for immobility. - CORRECT ANSWER-
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Rapid evaluation and when possible early liberation from spine boards and cervical collars will minimize co
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mplications.



True or False: Fall prevention is the mainstay of reducing the mortality associated with pelvic fractures. -
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CORRECT ANSWER-true
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