ATLS LATEST Exam
QUESTIONS AND ANSWERS
GRADED A+
An 8-year-old girl is an unrestrained passenger in a vehicle struck from
behind. In the ED, her blood pressure is 80/60mmHg, heart rate is 80 beats
per minute, and respiratory rate is 16 breaths per minute. Her GCS score
is 14. She complains that her legs feel "funny and wont move right".
However, her spine x-rays do not show a fracture or dislocation. A spinal
cord injury in this child:
A. Is most likely a central cord syndrome
B. Must be diagnosed by magnetic resonance imaging
C. Can be excluded by obtaining a CT-scan of the entire spine
D. May exist in the abscence of objective findings on x-ray studies
E. Is unlikely because of the incomplete calcification of the vertebral
bodies.
D. May exist in the abscence of objective findings on x-ray studies
Immediate chest tube insertion is indicated for which of the following
conditions?
A. Pneumothorax
B. Pneumomediastinum
C. Massive hemothorax
D. Diaphragmatic rupture
E. Subcutaneous emphysema
,C. Massive hemothorax
Cardiac tamponade after trauma:
A. Is seldom life-threating
B. Can be excluded by an upright, AP chest x-ray
C. Can be confused with a tension pneumthorax
D. Causes a fall in systolic pressure of > 15mmHg with expiration
E. Most commonly occurs after blunt injury to the anterior chest wall
C. Can be confused with a tension pneumothorax
All of the following statement regarding pulse oxymetry are true EXCEPT
A. excessive surrounding room light can interfere with the accuracy of the
reading
B. Significant levels of dysfunctional hemoglobin can affect the accuracy of
the reading
C. It provides a continuous measurement of the partial pressure of oxygen
D. It is dependent on differential light absorption by oxygenated and
deoxygenated hemoglobin
E. It provides a continuous, non-invasiv measurement of pulse rate that is
updated with each HR
C. It provides a continuous measurement of the partial pressure of oxygen
Bronchial intubation at the right or left mainstem bronchus can easily
occuring during infant endotracheal intubation because
A. The trachea is relatively short
B. The distance from the lips to the larynx is relatively short
C. The use of tubes without cuffs allow the tube to slip easily
D. The mainstem bronchi are less angulated in their relation to the trachea
E. Do litte friction exist between endotracheal tube and the wall of the
trachea.
A. The trachea is relatively short
,A 52 y/o woman sustaining 50% total body surface burns in an explosion.
She has burns around the chest and both upper arms. Adequate
resuscitation is initiated. She is nasotracheally intubated and is being
mechanically ventilated. Her CarboxyHb level is 10%. Her arterial blood
gas reveals PaO2 of 40mmHg, PaCo2 of 60mmHg and pH of 7,25.
Appropriate immediate management at the time is to
A. Ensure adequate tissue perfusion
B. Increase the rate of fluid resuscitation
C. Add PEEP
D. Reassess for the presence of pneumothorax
E. Administer IV narcotics in small amounts
?A. Ensure adequate tissue perfusion
All of the following suggest urethral injury EXCEPT
A. scrotal hematoma
B. Blood in rectal lumen
C. Blod in external urethral meatus
D. High riding prostate on rectal exam
E. Absence of a palpable prostate on rectal exam
E. Absence of a palpable prostate on rectal exam
A 22-year-old man is brought to the hospital after crashing his motorcycle
into a telephone pole. He is unconscious and in profound shock. He has no
open wounds or obvious fractures. The cause of his shock is MOST
LIKELY caused by:
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
E. Hemorrhage into the chest or abdomen
Which of the following statements is FALSE concerning Rh-
isoimmunization in the pregnant trauma patient?
A. It occurs in blunt or penetrating abdominal trauma
B. Minor degrees of fetomaternal hemorrhage produce it
C. A negative Kleihauer-Betke test excludes Rh-Isoimmunzation
D. This is not a problem in the traumatized Rh-positive pregnant patient
E. Initiation of Rh-immunoglobulin therapy does not require proof of
fetomaternal hemorrhage
C. A negative Kleihauer-Betke test excludes Rh-Isoimmunzation
All of the following signs on the chest x-ray of a blunt injury victim may
suggest aortic rupture EXCEPT:
A. Mediastinal emphysema
B. Presence of a "pleural cap"
C. Obliteration of the aortic knob
D. Deviation of the trachea to the right
E. Depression of the left mainstem bronchus
A. Mediastinal emphysema
Early central venous pressure monitoring during fluid resusciation in the
ED has the greatest utility in a:
A. Patient with a splenic laceration
B. Patient with a inhalation injury
C. 6 year-old child with a pelvic fracture
D. Patient with a severe cardiac contusion
E. 24-year-old man with a massive hemothorax
D. Patient with a severe cardiac contusion
QUESTIONS AND ANSWERS
GRADED A+
An 8-year-old girl is an unrestrained passenger in a vehicle struck from
behind. In the ED, her blood pressure is 80/60mmHg, heart rate is 80 beats
per minute, and respiratory rate is 16 breaths per minute. Her GCS score
is 14. She complains that her legs feel "funny and wont move right".
However, her spine x-rays do not show a fracture or dislocation. A spinal
cord injury in this child:
A. Is most likely a central cord syndrome
B. Must be diagnosed by magnetic resonance imaging
C. Can be excluded by obtaining a CT-scan of the entire spine
D. May exist in the abscence of objective findings on x-ray studies
E. Is unlikely because of the incomplete calcification of the vertebral
bodies.
D. May exist in the abscence of objective findings on x-ray studies
Immediate chest tube insertion is indicated for which of the following
conditions?
A. Pneumothorax
B. Pneumomediastinum
C. Massive hemothorax
D. Diaphragmatic rupture
E. Subcutaneous emphysema
,C. Massive hemothorax
Cardiac tamponade after trauma:
A. Is seldom life-threating
B. Can be excluded by an upright, AP chest x-ray
C. Can be confused with a tension pneumthorax
D. Causes a fall in systolic pressure of > 15mmHg with expiration
E. Most commonly occurs after blunt injury to the anterior chest wall
C. Can be confused with a tension pneumothorax
All of the following statement regarding pulse oxymetry are true EXCEPT
A. excessive surrounding room light can interfere with the accuracy of the
reading
B. Significant levels of dysfunctional hemoglobin can affect the accuracy of
the reading
C. It provides a continuous measurement of the partial pressure of oxygen
D. It is dependent on differential light absorption by oxygenated and
deoxygenated hemoglobin
E. It provides a continuous, non-invasiv measurement of pulse rate that is
updated with each HR
C. It provides a continuous measurement of the partial pressure of oxygen
Bronchial intubation at the right or left mainstem bronchus can easily
occuring during infant endotracheal intubation because
A. The trachea is relatively short
B. The distance from the lips to the larynx is relatively short
C. The use of tubes without cuffs allow the tube to slip easily
D. The mainstem bronchi are less angulated in their relation to the trachea
E. Do litte friction exist between endotracheal tube and the wall of the
trachea.
A. The trachea is relatively short
,A 52 y/o woman sustaining 50% total body surface burns in an explosion.
She has burns around the chest and both upper arms. Adequate
resuscitation is initiated. She is nasotracheally intubated and is being
mechanically ventilated. Her CarboxyHb level is 10%. Her arterial blood
gas reveals PaO2 of 40mmHg, PaCo2 of 60mmHg and pH of 7,25.
Appropriate immediate management at the time is to
A. Ensure adequate tissue perfusion
B. Increase the rate of fluid resuscitation
C. Add PEEP
D. Reassess for the presence of pneumothorax
E. Administer IV narcotics in small amounts
?A. Ensure adequate tissue perfusion
All of the following suggest urethral injury EXCEPT
A. scrotal hematoma
B. Blood in rectal lumen
C. Blod in external urethral meatus
D. High riding prostate on rectal exam
E. Absence of a palpable prostate on rectal exam
E. Absence of a palpable prostate on rectal exam
A 22-year-old man is brought to the hospital after crashing his motorcycle
into a telephone pole. He is unconscious and in profound shock. He has no
open wounds or obvious fractures. The cause of his shock is MOST
LIKELY caused by:
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
E. Hemorrhage into the chest or abdomen
Which of the following statements is FALSE concerning Rh-
isoimmunization in the pregnant trauma patient?
A. It occurs in blunt or penetrating abdominal trauma
B. Minor degrees of fetomaternal hemorrhage produce it
C. A negative Kleihauer-Betke test excludes Rh-Isoimmunzation
D. This is not a problem in the traumatized Rh-positive pregnant patient
E. Initiation of Rh-immunoglobulin therapy does not require proof of
fetomaternal hemorrhage
C. A negative Kleihauer-Betke test excludes Rh-Isoimmunzation
All of the following signs on the chest x-ray of a blunt injury victim may
suggest aortic rupture EXCEPT:
A. Mediastinal emphysema
B. Presence of a "pleural cap"
C. Obliteration of the aortic knob
D. Deviation of the trachea to the right
E. Depression of the left mainstem bronchus
A. Mediastinal emphysema
Early central venous pressure monitoring during fluid resusciation in the
ED has the greatest utility in a:
A. Patient with a splenic laceration
B. Patient with a inhalation injury
C. 6 year-old child with a pelvic fracture
D. Patient with a severe cardiac contusion
E. 24-year-old man with a massive hemothorax
D. Patient with a severe cardiac contusion
