ATLS Metabolic Response to Severe
Injury Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
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1. Which physiologic response is most characteristic of the early
metabolic phase after severe trauma?
A. Decreased sympathetic activity
B. Increased catecholamine release
C. Increased insulin sensitivity
D. Suppressed cortisol secretion
Answer: B. Increased catecholamine release
Rationale: Severe injury activates the sympathetic nervous system and
hypothalamic-pituitary-adrenal axis, producing increased
catecholamines, cortisol, glucagon, and inflammatory mediators.
These changes support cardiovascular function and mobilize
metabolic substrates for the stress response.
2. What is the principal metabolic purpose of the acute stress
response following major trauma?
A. Promote long-term fat storage
B. Reduce oxygen delivery to tissues
C. Provide substrates and energy for survival
D. Prevent protein breakdown completely
Answer: C. Provide substrates and energy for survival
,Rationale: The trauma response mobilizes glucose, fatty acids, and
amino acids to support vital organs, immune activity, tissue repair, and
cardiovascular function. This adaptive response becomes harmful
when excessive or prolonged.
3. Which hormone generally promotes hyperglycemia during severe
injury?
A. Insulin
B. Glucagon
C. Calcitonin
D. Melatonin
Answer: B. Glucagon
Rationale: Glucagon increases hepatic glycogenolysis and
gluconeogenesis. During trauma, increased glucagon acts with
catecholamines and cortisol to raise circulating glucose and provide
readily available fuel.
4. Which endocrine change contributes most directly to trauma-
associated insulin resistance?
A. Increased insulin sensitivity
B. Increased counterregulatory hormones
C. Complete suppression of glucagon
D. Reduced catecholamine production
Answer: B. Increased counterregulatory hormones
Rationale: Catecholamines, cortisol, glucagon, and growth hormone
oppose insulin action. Their elevation during severe injury promotes
hepatic glucose production and reduces peripheral glucose uptake,
contributing to stress hyperglycemia.
, 5. Which organ is the major site of hepatic gluconeogenesis during
the trauma response?
A. Liver
B. Spleen
C. Heart
D. Thyroid
Answer: A. Liver
Rationale: The liver is the principal site of gluconeogenesis and
glycogenolysis during the acute stress response. It releases glucose
into the circulation to support tissues with high metabolic
requirements.
6. Which substrate is commonly released from skeletal muscle for
hepatic gluconeogenesis after severe injury?
A. Amino acids
B. Cholesterol only
C. Bile acids
D. Calcium
Answer: A. Amino acids
Rationale: Proteolysis releases amino acids, particularly alanine and
glutamine, that can be used for gluconeogenesis and immune or
reparative processes. Persistent proteolysis contributes to trauma-
associated muscle wasting.
7. What is the term for increased blood glucose associated with
severe physiologic stress despite no previous diagnosis of
diabetes?
A. Reactive hypoglycemia
B. Stress hyperglycemia
, C. Starvation ketosis
D. Diabetes insipidus
Answer: B. Stress hyperglycemia
Rationale: Trauma-induced hormonal and inflammatory changes
increase glucose production and impair insulin-mediated glucose
utilization. Stress hyperglycemia may occur in patients without
preexisting diabetes and often correlates with injury severity.
8. Which hormone is primarily anabolic under normal conditions?
A. Insulin
B. Cortisol
C. Glucagon
D. Epinephrine
Answer: A. Insulin
Rationale: Insulin promotes glucose uptake, glycogen synthesis,
protein synthesis, and fat storage. Severe trauma reduces the
effectiveness of these anabolic processes because counterregulatory
hormones and inflammatory mediators dominate.
9. Which metabolic process breaks down stored glycogen to release
glucose?
A. Glycogenesis
B. Glycogenolysis
C. Lipogenesis
D. Proteogenesis
Answer: B. Glycogenolysis
Rationale: Glycogenolysis is the breakdown of glycogen into glucose
or glucose intermediates. Catecholamines and glucagon stimulate this
process during the early response to injury.
Injury Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. Which physiologic response is most characteristic of the early
metabolic phase after severe trauma?
A. Decreased sympathetic activity
B. Increased catecholamine release
C. Increased insulin sensitivity
D. Suppressed cortisol secretion
Answer: B. Increased catecholamine release
Rationale: Severe injury activates the sympathetic nervous system and
hypothalamic-pituitary-adrenal axis, producing increased
catecholamines, cortisol, glucagon, and inflammatory mediators.
These changes support cardiovascular function and mobilize
metabolic substrates for the stress response.
2. What is the principal metabolic purpose of the acute stress
response following major trauma?
A. Promote long-term fat storage
B. Reduce oxygen delivery to tissues
C. Provide substrates and energy for survival
D. Prevent protein breakdown completely
Answer: C. Provide substrates and energy for survival
,Rationale: The trauma response mobilizes glucose, fatty acids, and
amino acids to support vital organs, immune activity, tissue repair, and
cardiovascular function. This adaptive response becomes harmful
when excessive or prolonged.
3. Which hormone generally promotes hyperglycemia during severe
injury?
A. Insulin
B. Glucagon
C. Calcitonin
D. Melatonin
Answer: B. Glucagon
Rationale: Glucagon increases hepatic glycogenolysis and
gluconeogenesis. During trauma, increased glucagon acts with
catecholamines and cortisol to raise circulating glucose and provide
readily available fuel.
4. Which endocrine change contributes most directly to trauma-
associated insulin resistance?
A. Increased insulin sensitivity
B. Increased counterregulatory hormones
C. Complete suppression of glucagon
D. Reduced catecholamine production
Answer: B. Increased counterregulatory hormones
Rationale: Catecholamines, cortisol, glucagon, and growth hormone
oppose insulin action. Their elevation during severe injury promotes
hepatic glucose production and reduces peripheral glucose uptake,
contributing to stress hyperglycemia.
, 5. Which organ is the major site of hepatic gluconeogenesis during
the trauma response?
A. Liver
B. Spleen
C. Heart
D. Thyroid
Answer: A. Liver
Rationale: The liver is the principal site of gluconeogenesis and
glycogenolysis during the acute stress response. It releases glucose
into the circulation to support tissues with high metabolic
requirements.
6. Which substrate is commonly released from skeletal muscle for
hepatic gluconeogenesis after severe injury?
A. Amino acids
B. Cholesterol only
C. Bile acids
D. Calcium
Answer: A. Amino acids
Rationale: Proteolysis releases amino acids, particularly alanine and
glutamine, that can be used for gluconeogenesis and immune or
reparative processes. Persistent proteolysis contributes to trauma-
associated muscle wasting.
7. What is the term for increased blood glucose associated with
severe physiologic stress despite no previous diagnosis of
diabetes?
A. Reactive hypoglycemia
B. Stress hyperglycemia
, C. Starvation ketosis
D. Diabetes insipidus
Answer: B. Stress hyperglycemia
Rationale: Trauma-induced hormonal and inflammatory changes
increase glucose production and impair insulin-mediated glucose
utilization. Stress hyperglycemia may occur in patients without
preexisting diabetes and often correlates with injury severity.
8. Which hormone is primarily anabolic under normal conditions?
A. Insulin
B. Cortisol
C. Glucagon
D. Epinephrine
Answer: A. Insulin
Rationale: Insulin promotes glucose uptake, glycogen synthesis,
protein synthesis, and fat storage. Severe trauma reduces the
effectiveness of these anabolic processes because counterregulatory
hormones and inflammatory mediators dominate.
9. Which metabolic process breaks down stored glycogen to release
glucose?
A. Glycogenesis
B. Glycogenolysis
C. Lipogenesis
D. Proteogenesis
Answer: B. Glycogenolysis
Rationale: Glycogenolysis is the breakdown of glycogen into glucose
or glucose intermediates. Catecholamines and glucagon stimulate this
process during the early response to injury.
