ATLS POST TEST
22 12 months antique male fall from 2m, big proper pneumothorax. Chest tube positioned,
connected to drainage. Control x-ray indicates pneumothorax, 0.33 x-ray exhibits
pneumothorax - ANS-Tracheobronchal harm
30-year-vintage female fell down four stair touchdown on concrete. Unconscious for five
minutes after the fall, full cognizance at some stage in 10 minute delivery to health facility,
GCS 15, criticism is a moderate headache, 30 minute later she is unresponsive with GCS 6
and left student is large. - ANS-Epidural hematoma
A 14 yr antique female is added to the ED after falling from a horse. She is immobilized on
an extended spine board with a hard collar and blocks. Cervical spine x-ray:
A. Will display cervical spine damage in greater than 20% of those patients
B. Will exclude cervical backbone harm if no abnormalities are located at the x-rays
C. Are now not needed if she is awake, alert, neurologically everyday, and has no neck pain
or midline tenderness
D. Should be performed earlier than adressing ability breating or circulatory problems
E. May display atlanto-occipital dislocation if the Powers ratio is <1 --> 1:noraml, >1 anterior,
<1 posterior - ANS-C. Are not wished if she is wakeful, alert, neurologically everyday, and
has no neck pain or midline tenderness
A 15 yr vintage male is added to the ED after being concerned in a motor vehicle crash. He
is subconscious and become intubated at the scene by using emergency employees. Upon
arrival at the ED, the sufferers oxygen saturation is 92%, HR is ninety six bpm and BP is one
hundred fifty/eighty five Breath sounds are reduced at the left side of the thorax. The
subsequent 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 - ANS-B. Reassess the placement of the endotracheal tube
A 15 12 months vintage male gift following a bike crash. INitial examinations famous normal
important signs and symptoms. There is a large bruise over his epigastrium that extends to
the left flank. He has no different apparent accidents. A CT-experiment of the abdomen
reveal a ruptured spleen surrounded through a huge hematoma and fluid inside the pelvis.
The next step in the sufferers management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician - ANS-D. Surgical consult
Hemodynamisk stabil, ingen fri luft.
,A 17 year vintage girl is added to the ED following a 2 meter fall onto concrete. She is
unresponsive and located 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 reduced level of consciousness
D. Applying oxygen and preserving airway
E. Excluding hemorrhage as a cause of surprise - ANS-D. Applying oxygen and preserving
airway
A 17-12 months-old helmeted motorcyclist is struck broadside via an car at an intersection.
He is subconscious on the scene with a blood strain of a hundred and forty/90mmHg, heart
price of ninety beats consistent with minute, and respiratory charge of twenty-two breaths in
step with minute. His respirations are sonorous and deep. His GCS rating is 6.
Immobilization of the complete patient may additionally include the usage of all of the
following EXCEPT:
A. Air splints
B. Bolstering devices
C. A lengthy backbone board
D. A scoop-style stretcher
E. A semi-rigid cervical collar - ANS-A. Air splints
A 17-12 months-old helmeted motorcyclist loses awareness while he is struck wide facet by
way of an car at an intersection. He arrives inside the ED with a blood strain of one hundred
forty/92, pulse price 88 beats in step with minute, a respiration charge of 18 breaths in line
with minue, and a GCS of seven. Appropriate initial immobilization of this affected person
need to encompass a semi-inflexible cervical collar and:
A. A scoop stretcher
B. A long backbone board
C. A brief spine board
D. Cervical traction tongs
E. Pneumatic antishock garment - ANS-B. A long spine board
A 20 year antique athlete is worried in a motorbike crash. When he arrives inside the ED, he
shouts that he cannot pass his legs. On physical exam, there are noe abnormalities of the
chest, abdomen or pelvis. The affected person has no sensation in his legs and can not flow
them, however his hands are moving. The sufferers RR is 28 bpm, HR is 88bpm and BP is
80/60mmHg. He is faded and sweaty. What is the most probably purpose of this
circumstance?
A. Neurogenic surprise
B. Cardiogenic shock
C. Abdominal hemorrhage
D. Myocardial contusion
E. Hyperthermia. - ANS-A. Neurogenic surprise
A 20 12 months antique male is added to the clinic approximately 30 minutes after being
stabbed in the chest. There is 3cm wound simply 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 get right of entry to has been established and warm crystalloid is infusing.
The next maximum critical aspect of instantaneous management is:
A. CT scan of the chest
B. 12 lead ECG
C. Left tube thoracostomy
D. Begin infusion of RBCs
E. FAST examination - ANS-E. FAST examination 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
A 20-year-antique woman, at 32 weeks gestation, is stabbed inside the upper proper chest.
In the ED, her blood stress is eighty/60mmHg. She is gasping for breath, extremely
annoying, and yelling for help. Breath sounds are faded within the right chest. The most
appropriate first step is to:
A. Perform tracheal intubation
B. Insert an oropharyngeal airway
C. Perform needle decompression of the proper chest
D. Manually displace the gravid uterus to the left aspect of the stomach
E. Initiate 2 huge-quality peripheral IV lines and crystalloid infusion - ANS-C. Perform needle
decompression of the proper chest
A 22 12 months antique male is assaulted in a bar. A semi-rigid cervical collar is applied and
he is immobilized on a spine board. On initial examination, his critical signs are ordinary, and
his GCS is 15. Which of the following is an indication for CT on this affected person with
feasible minor annoying brain injury?
A. Blood alcohol concentration of 0,16%
B. Presence of an remoted 10cm scalp laceration
C. Presence of a mandibular fracture
D. Presence of hemotympanum
E. History of attack - ANS-D. Presence of hemotympanum
A 22 year antique male present following a bike crash. He complains of the incapability to
move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is ninety
nine% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are
ordinary. His control ought to be:
A: 2L of iv . Crystalloid and two gadgets of pRBCs
B. 2L of iv crystalloid and vasopressors if BP does not reply
C. 2L of iv. Crystalloid, mannitol and iv steroids
D. Vasopressors and laparotomy
E. 1 unit of albumin and compression stockings - ANS-B. 2L of iv crystalloid and
vasopressors if BP does now not reply
A 22 year old male sustains a shotgun wound to the left shoulder and chest at close range.
His BP is 80/40mmHg and his HR is 130bpm. After 2 liters of crystalloid solution are rapidly
infused, his BP increases to 122/eighty four, and HR decreases to 100bpm. He is tachypneic
with RR of 28. On bodily exam, his breath sounds are reduced on the left top chest with
dullness on percussion. A large quality (36 french) tube thoracostomy is inserted inside the
, 5th intercostal space with the return of 200ml of blood and no air leak. The maximum
suitable subsequent step is to:
A. Insert a foley catheter
B. Begin to transfuse o-bad blood
C. Perform thoracotomy
D. Obtain a CT-experiment of chest and abdomen
E. Repeat the physical examination of the chest - ANS-E. Repeat the physical examination
of the chest
A 22-12 months-vintage lady athlete is stabbed in her left chest on the third interspace in the
anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
unsleeping and alert. Her coronary heart rate is 100 beats in step with minute, BP
80/60mmHg, and breathing rate is 20 breaths in keeping with minute. A chest x-ray exhibits
a big left hemithorax. A left chest tube is placed with a direct return of 1600ml of blood. The
subsequent management step for this patient is:
A. Carry out a thoracoscopy
B. Perform an arch aortogram
C. Insert a 2d left chest tube
D. Prepare for an exploratory thoracotomy
E. Perform a chest CT - ANS-D. Prepare for an exploratory thoracotomy
A 22-12 months-old guy is delivered to the medical institution after crashing his bike into a
telephone pole. He is subconscious and in profound shock. He has no open wounds or
obvious fractures. The reason of his surprise is MOST LIKELY because of:
A. A subdural hematoma
B. An epidural hematoma
C. A transected lumbar spinal cord
D. A basilar skull fracture
E. Hemorrhage into the chest or abdomen - ANS-E. Hemorrhage into the chest or stomach
A 22-yr-vintage guy is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His BP is to begin with 80/40mmHg. After 2 liters of crystalloid solution his blood
pressure will increase to 122/84mmHg. His heart charge is now 100 beats in keeping with
minute and his respiration charge is 28 breaths according to minute. His breath sounds are
decreased inside the left hemithorax, and after preliminary IV fluid resusciation, a closed
tube thoracostomy is achieved for reduced left breath sound with the go back of small
quantity of blood and no air leak. After chest tube insertion, the maximum suitable next step
is to:
A. Reexamine the chest
B. Perform an aortogram
C. Obtain a CT-experiment of the chest
D. Obtain arterial blood gasoline analyses
E. Perform transesophageal echocardiography - ANS-A. Reexamine the chest
A 22-year-vintage man sustains a gunshot wound to the left chest and is transported to a
small community medical institution at which surgical capabilites aren't available. In the ED,
a chest tube is inserted and 700ml of blood is evacuted. The trauma center accepts the
affected person in switch. Just earlier than the patient is located in an ambulance for switch,
22 12 months antique male fall from 2m, big proper pneumothorax. Chest tube positioned,
connected to drainage. Control x-ray indicates pneumothorax, 0.33 x-ray exhibits
pneumothorax - ANS-Tracheobronchal harm
30-year-vintage female fell down four stair touchdown on concrete. Unconscious for five
minutes after the fall, full cognizance at some stage in 10 minute delivery to health facility,
GCS 15, criticism is a moderate headache, 30 minute later she is unresponsive with GCS 6
and left student is large. - ANS-Epidural hematoma
A 14 yr antique female is added to the ED after falling from a horse. She is immobilized on
an extended spine board with a hard collar and blocks. Cervical spine x-ray:
A. Will display cervical spine damage in greater than 20% of those patients
B. Will exclude cervical backbone harm if no abnormalities are located at the x-rays
C. Are now not needed if she is awake, alert, neurologically everyday, and has no neck pain
or midline tenderness
D. Should be performed earlier than adressing ability breating or circulatory problems
E. May display atlanto-occipital dislocation if the Powers ratio is <1 --> 1:noraml, >1 anterior,
<1 posterior - ANS-C. Are not wished if she is wakeful, alert, neurologically everyday, and
has no neck pain or midline tenderness
A 15 yr vintage male is added to the ED after being concerned in a motor vehicle crash. He
is subconscious and become intubated at the scene by using emergency employees. Upon
arrival at the ED, the sufferers oxygen saturation is 92%, HR is ninety six bpm and BP is one
hundred fifty/eighty five Breath sounds are reduced at the left side of the thorax. The
subsequent 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 - ANS-B. Reassess the placement of the endotracheal tube
A 15 12 months vintage male gift following a bike crash. INitial examinations famous normal
important signs and symptoms. There is a large bruise over his epigastrium that extends to
the left flank. He has no different apparent accidents. A CT-experiment of the abdomen
reveal a ruptured spleen surrounded through a huge hematoma and fluid inside the pelvis.
The next step in the sufferers management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician - ANS-D. Surgical consult
Hemodynamisk stabil, ingen fri luft.
,A 17 year vintage girl is added to the ED following a 2 meter fall onto concrete. She is
unresponsive and located 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 reduced level of consciousness
D. Applying oxygen and preserving airway
E. Excluding hemorrhage as a cause of surprise - ANS-D. Applying oxygen and preserving
airway
A 17-12 months-old helmeted motorcyclist is struck broadside via an car at an intersection.
He is subconscious on the scene with a blood strain of a hundred and forty/90mmHg, heart
price of ninety beats consistent with minute, and respiratory charge of twenty-two breaths in
step with minute. His respirations are sonorous and deep. His GCS rating is 6.
Immobilization of the complete patient may additionally include the usage of all of the
following EXCEPT:
A. Air splints
B. Bolstering devices
C. A lengthy backbone board
D. A scoop-style stretcher
E. A semi-rigid cervical collar - ANS-A. Air splints
A 17-12 months-old helmeted motorcyclist loses awareness while he is struck wide facet by
way of an car at an intersection. He arrives inside the ED with a blood strain of one hundred
forty/92, pulse price 88 beats in step with minute, a respiration charge of 18 breaths in line
with minue, and a GCS of seven. Appropriate initial immobilization of this affected person
need to encompass a semi-inflexible cervical collar and:
A. A scoop stretcher
B. A long backbone board
C. A brief spine board
D. Cervical traction tongs
E. Pneumatic antishock garment - ANS-B. A long spine board
A 20 year antique athlete is worried in a motorbike crash. When he arrives inside the ED, he
shouts that he cannot pass his legs. On physical exam, there are noe abnormalities of the
chest, abdomen or pelvis. The affected person has no sensation in his legs and can not flow
them, however his hands are moving. The sufferers RR is 28 bpm, HR is 88bpm and BP is
80/60mmHg. He is faded and sweaty. What is the most probably purpose of this
circumstance?
A. Neurogenic surprise
B. Cardiogenic shock
C. Abdominal hemorrhage
D. Myocardial contusion
E. Hyperthermia. - ANS-A. Neurogenic surprise
A 20 12 months antique male is added to the clinic approximately 30 minutes after being
stabbed in the chest. There is 3cm wound simply 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 get right of entry to has been established and warm crystalloid is infusing.
The next maximum critical aspect of instantaneous management is:
A. CT scan of the chest
B. 12 lead ECG
C. Left tube thoracostomy
D. Begin infusion of RBCs
E. FAST examination - ANS-E. FAST examination 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
A 20-year-antique woman, at 32 weeks gestation, is stabbed inside the upper proper chest.
In the ED, her blood stress is eighty/60mmHg. She is gasping for breath, extremely
annoying, and yelling for help. Breath sounds are faded within the right chest. The most
appropriate first step is to:
A. Perform tracheal intubation
B. Insert an oropharyngeal airway
C. Perform needle decompression of the proper chest
D. Manually displace the gravid uterus to the left aspect of the stomach
E. Initiate 2 huge-quality peripheral IV lines and crystalloid infusion - ANS-C. Perform needle
decompression of the proper chest
A 22 12 months antique male is assaulted in a bar. A semi-rigid cervical collar is applied and
he is immobilized on a spine board. On initial examination, his critical signs are ordinary, and
his GCS is 15. Which of the following is an indication for CT on this affected person with
feasible minor annoying brain injury?
A. Blood alcohol concentration of 0,16%
B. Presence of an remoted 10cm scalp laceration
C. Presence of a mandibular fracture
D. Presence of hemotympanum
E. History of attack - ANS-D. Presence of hemotympanum
A 22 year antique male present following a bike crash. He complains of the incapability to
move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is ninety
nine% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are
ordinary. His control ought to be:
A: 2L of iv . Crystalloid and two gadgets of pRBCs
B. 2L of iv crystalloid and vasopressors if BP does not reply
C. 2L of iv. Crystalloid, mannitol and iv steroids
D. Vasopressors and laparotomy
E. 1 unit of albumin and compression stockings - ANS-B. 2L of iv crystalloid and
vasopressors if BP does now not reply
A 22 year old male sustains a shotgun wound to the left shoulder and chest at close range.
His BP is 80/40mmHg and his HR is 130bpm. After 2 liters of crystalloid solution are rapidly
infused, his BP increases to 122/eighty four, and HR decreases to 100bpm. He is tachypneic
with RR of 28. On bodily exam, his breath sounds are reduced on the left top chest with
dullness on percussion. A large quality (36 french) tube thoracostomy is inserted inside the
, 5th intercostal space with the return of 200ml of blood and no air leak. The maximum
suitable subsequent step is to:
A. Insert a foley catheter
B. Begin to transfuse o-bad blood
C. Perform thoracotomy
D. Obtain a CT-experiment of chest and abdomen
E. Repeat the physical examination of the chest - ANS-E. Repeat the physical examination
of the chest
A 22-12 months-vintage lady athlete is stabbed in her left chest on the third interspace in the
anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
unsleeping and alert. Her coronary heart rate is 100 beats in step with minute, BP
80/60mmHg, and breathing rate is 20 breaths in keeping with minute. A chest x-ray exhibits
a big left hemithorax. A left chest tube is placed with a direct return of 1600ml of blood. The
subsequent management step for this patient is:
A. Carry out a thoracoscopy
B. Perform an arch aortogram
C. Insert a 2d left chest tube
D. Prepare for an exploratory thoracotomy
E. Perform a chest CT - ANS-D. Prepare for an exploratory thoracotomy
A 22-12 months-old guy is delivered to the medical institution after crashing his bike into a
telephone pole. He is subconscious and in profound shock. He has no open wounds or
obvious fractures. The reason of his surprise is MOST LIKELY because of:
A. A subdural hematoma
B. An epidural hematoma
C. A transected lumbar spinal cord
D. A basilar skull fracture
E. Hemorrhage into the chest or abdomen - ANS-E. Hemorrhage into the chest or stomach
A 22-yr-vintage guy is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His BP is to begin with 80/40mmHg. After 2 liters of crystalloid solution his blood
pressure will increase to 122/84mmHg. His heart charge is now 100 beats in keeping with
minute and his respiration charge is 28 breaths according to minute. His breath sounds are
decreased inside the left hemithorax, and after preliminary IV fluid resusciation, a closed
tube thoracostomy is achieved for reduced left breath sound with the go back of small
quantity of blood and no air leak. After chest tube insertion, the maximum suitable next step
is to:
A. Reexamine the chest
B. Perform an aortogram
C. Obtain a CT-experiment of the chest
D. Obtain arterial blood gasoline analyses
E. Perform transesophageal echocardiography - ANS-A. Reexamine the chest
A 22-year-vintage man sustains a gunshot wound to the left chest and is transported to a
small community medical institution at which surgical capabilites aren't available. In the ED,
a chest tube is inserted and 700ml of blood is evacuted. The trauma center accepts the
affected person in switch. Just earlier than the patient is located in an ambulance for switch,
