TCRN EXAM REVIEW QUESTIONS WITH 100% ACCURATE ANSWERS
Circumfrential burns - (ANSWER)Full-thickness burns result in the formation of an eschar that is tough
and unyielding.
Can cause a burn compartment syndrome, and often requires escharotomy
Shock - (ANSWER)Systemic reaction to insult that causes decreased oxygen delivery to the cells
4 Classifications of Shock - (ANSWER)1. Hypovolemic
2. Distributive
3. Cardiogenic
4. Obstruction
Hypovolemic Shock - (ANSWER)Low blood volume results in altered perfusion (Ex: Hemorrhage, third
spacing)
Distributive Shock - (ANSWER)Severe vasodilation with normal blood volume results in altered perfusion
(Ex: Sepsis, anaphylaxis, neurogenic)
Cardiogenic Shock - (ANSWER)Altered cardiac function results in reduced perfusion (Ex: Blunt chest
injury, CHF)
Obstructive Shock - (ANSWER)Blockage in the system causes altered perfusion (Ex: PE, high PEEP,
tension pneumothorax)
Alpha Receptors - (ANSWER)Activated by sympathetic nervous system, causing:
Vasoconstriction
Glycogenolysis
Diaphoresis
,TCRN EXAM REVIEW QUESTIONS WITH 100% ACCURATE ANSWERS
Glycogenolysis - (ANSWER)Breakdown of glucose stores in the liver to provide increased circulating
glucose, stimulated by Alpha receptors
Beta 1 Receptors - (ANSWER)*Think: 1 heart
Cause increased heart rate and contractility
Beta 2 receptors - (ANSWER)*Think: 2 lungs
Cause bronchodilation and increased respiratory rate
RAAS System - (ANSWER)Increases resorption of sodium and water in the kidneys to increase vascular
volume, decreasing urine output
3 hr. Sepsis Bundle - (ANSWER)Lactic level
Blood cultures before antibiotics
Broad spectrum antibiotics
30 ml/kg fluid bolus for hypotension
6 hr. Sepsis Bundle - (ANSWER)Repeat lactic
Start pressors if fluid bolus ineffective
Gain central access for pressors
Symptoms of Early Shock - (ANSWER)Normotensive with NARROWING pulse pressure
Tachycardia
Weak and thready pulse
Tachypnea with DEEP respirations
Normal lactic
Cool and clammy
,TCRN EXAM REVIEW QUESTIONS WITH 100% ACCURATE ANSWERS
Anxiety, impending doom
Decreased urine output
Symptoms of Late Shock - (ANSWER)Hypotension
Tachycardia
Tachypnea with shallow respirations
Elevated lactic
Cool, clammy, and mottled skin
Confusion, decreased LOC
SUPER decreased to no urine output
Stages of Shock - (ANSWER)1. Early (Compensatory)
2. Late (Decompensated)
3. Irreversible
Irreversible Shock Symptoms - (ANSWER)MODS
Severe acidosis
Obtunded
Cardiac arrest
Trauma Triad of Death - (ANSWER)Hypothermia
Acidosis
Coagulopathy
Symptoms of Hypothermia - (ANSWER)Decreased cardiac output and HR (reduced perfusion)
Vasoconstriction
Depressed CNS
, TCRN EXAM REVIEW QUESTIONS WITH 100% ACCURATE ANSWERS
Bleeding due to decreased coagulation
Symptoms of acidosis - (ANSWER)Decreased myocardial contractility
Prolonged PTT
Increased risk of dysrhythmias
SIRS
Explain the trauma triad of death - (ANSWER)Hypothermia causes coagulopathies which worsen
acidosis, causing cardiac dysfunction and further worsening shock
What blood product is administered for low fibrinogen levels? - (ANSWER)Cryo
What blood product is used to address increased PT/PTT? - (ANSWER)FFP
What blood product is used for thrombocytopenia? - (ANSWER)Platelets
Where should tourniquets be placed in relation to the injury? - (ANSWER)As close to the bleed as
possible to preserve as much limb as possible
Pneumoperitoneum - (ANSWER)Air in the peritoneal cavity that is related to a ruptured hollow organ
Displays as abdominal distention
Cullen's sign - (ANSWER)
Chance fractures - (ANSWER)Lumbar spine fractures caused by hyperflexion over a seat belt
Indications for TXA - (ANSWER)Indicated for SBP <90 or HR >110
Circumfrential burns - (ANSWER)Full-thickness burns result in the formation of an eschar that is tough
and unyielding.
Can cause a burn compartment syndrome, and often requires escharotomy
Shock - (ANSWER)Systemic reaction to insult that causes decreased oxygen delivery to the cells
4 Classifications of Shock - (ANSWER)1. Hypovolemic
2. Distributive
3. Cardiogenic
4. Obstruction
Hypovolemic Shock - (ANSWER)Low blood volume results in altered perfusion (Ex: Hemorrhage, third
spacing)
Distributive Shock - (ANSWER)Severe vasodilation with normal blood volume results in altered perfusion
(Ex: Sepsis, anaphylaxis, neurogenic)
Cardiogenic Shock - (ANSWER)Altered cardiac function results in reduced perfusion (Ex: Blunt chest
injury, CHF)
Obstructive Shock - (ANSWER)Blockage in the system causes altered perfusion (Ex: PE, high PEEP,
tension pneumothorax)
Alpha Receptors - (ANSWER)Activated by sympathetic nervous system, causing:
Vasoconstriction
Glycogenolysis
Diaphoresis
,TCRN EXAM REVIEW QUESTIONS WITH 100% ACCURATE ANSWERS
Glycogenolysis - (ANSWER)Breakdown of glucose stores in the liver to provide increased circulating
glucose, stimulated by Alpha receptors
Beta 1 Receptors - (ANSWER)*Think: 1 heart
Cause increased heart rate and contractility
Beta 2 receptors - (ANSWER)*Think: 2 lungs
Cause bronchodilation and increased respiratory rate
RAAS System - (ANSWER)Increases resorption of sodium and water in the kidneys to increase vascular
volume, decreasing urine output
3 hr. Sepsis Bundle - (ANSWER)Lactic level
Blood cultures before antibiotics
Broad spectrum antibiotics
30 ml/kg fluid bolus for hypotension
6 hr. Sepsis Bundle - (ANSWER)Repeat lactic
Start pressors if fluid bolus ineffective
Gain central access for pressors
Symptoms of Early Shock - (ANSWER)Normotensive with NARROWING pulse pressure
Tachycardia
Weak and thready pulse
Tachypnea with DEEP respirations
Normal lactic
Cool and clammy
,TCRN EXAM REVIEW QUESTIONS WITH 100% ACCURATE ANSWERS
Anxiety, impending doom
Decreased urine output
Symptoms of Late Shock - (ANSWER)Hypotension
Tachycardia
Tachypnea with shallow respirations
Elevated lactic
Cool, clammy, and mottled skin
Confusion, decreased LOC
SUPER decreased to no urine output
Stages of Shock - (ANSWER)1. Early (Compensatory)
2. Late (Decompensated)
3. Irreversible
Irreversible Shock Symptoms - (ANSWER)MODS
Severe acidosis
Obtunded
Cardiac arrest
Trauma Triad of Death - (ANSWER)Hypothermia
Acidosis
Coagulopathy
Symptoms of Hypothermia - (ANSWER)Decreased cardiac output and HR (reduced perfusion)
Vasoconstriction
Depressed CNS
, TCRN EXAM REVIEW QUESTIONS WITH 100% ACCURATE ANSWERS
Bleeding due to decreased coagulation
Symptoms of acidosis - (ANSWER)Decreased myocardial contractility
Prolonged PTT
Increased risk of dysrhythmias
SIRS
Explain the trauma triad of death - (ANSWER)Hypothermia causes coagulopathies which worsen
acidosis, causing cardiac dysfunction and further worsening shock
What blood product is administered for low fibrinogen levels? - (ANSWER)Cryo
What blood product is used to address increased PT/PTT? - (ANSWER)FFP
What blood product is used for thrombocytopenia? - (ANSWER)Platelets
Where should tourniquets be placed in relation to the injury? - (ANSWER)As close to the bleed as
possible to preserve as much limb as possible
Pneumoperitoneum - (ANSWER)Air in the peritoneal cavity that is related to a ruptured hollow organ
Displays as abdominal distention
Cullen's sign - (ANSWER)
Chance fractures - (ANSWER)Lumbar spine fractures caused by hyperflexion over a seat belt
Indications for TXA - (ANSWER)Indicated for SBP <90 or HR >110
