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Ab22byearboldbmalebisbbroughtbbybambulancebtobabsmallbcommunitybhospitalbaf
terbfallingbfrombthebtopbofbanb8bfootbladder.bInitially,bhebwasbfoundbtobhavebab
largebrightbpneumothorax.bAbchestbtubebwasbinsertedbandbconnectedbtobanbund
erwaterbsealbdrainagebcollectionbsystembwithbnegativebpressure.bAbrepeatbCXRb
demonstratesbabresidual,blargebrightbpneumothorax.bAfterbtransferringbthebpatient
btobabverifiedbtraumabcenter,babthirdbchestbx-
raybrevealsbabpersistentbrightbpneumothorax.bThebchestbtubebappearsbtobbebfun
ctioningbandbinbgoodbposition.bHebremainsbhemodynamicallybnormalbwithbnobsig
nsbofbrespiratorybdistress.bThebmostblikelybcausebforbthebpersistentbrightbpneum
othoraxbis:
A.bFlailbchest
B.bDiaphragmaticbinjury
C.bPulmonarybcontusion
D.bEsophagealbperforation
E.bTracheobronchialbinjuryb-bans-E.bTracheobronchialbinjury
WhichbofbthebfollowingbisbLEASTbreliablebforbdiagnosingbESOPHAGEALbintubatio
n?
A.bsymmetricalbchestbwallbmovement
B.bend-tidalbCO2
C.bbilateralbbreathbsounds
D.boxygenbsaturationb>92%
E.bETTbabovebcarinabonbchestbx-rayb-bans-D.boxygenbsaturationb>92%
->bifbitbsaysbESOPHAGEAL,bgobwithbthisbanswer
Whichbofbthebfollowingbsignsbnecessitatesbthebneedbforbabdefinitivebairwaybinbs
everebtraumabpatient?
,A.bfacialblacerations
B.brepeatedbvomiting
C.bseverebmaxillofacialbtrauma
D.bsternalbfracture
E.bGCSb12b-bans-C.bSeverebmaxillofacialbtrauma
Twentybsevenbpeoplebarebseverelybinjuredbinbanbaircraftbcrashbatbablocalbairport
.bThebprinciplesbofbtriagebinclude:
A.bestablishbabtriagebsitebwithinbthebinternalbperimeterbofbthebcrashbsite
B.btreatbonlybthebmostbseverelybinjuredbpatientsbfirst
C.bimmediatelybtransportballbpatientsbtobthebnearestbhospital
D.btreatbthebgreatestbnumberbofbpatientsbinbthebshortestbperiodbofbtime
E.bproducebthebgreatestbnumberbofbsurvivorsbbasedbonbavailablebresourcesb-
bans-E.bProducebthebgreatestbnumberbofbsurvivorsbbasedbonbavailablebresources
Whichbofbthebfollowingbstatementsbarebcorrect?
A.bCerebralbcontusionsbmaybcoalescebtobformbanbintracerebralbhematoma
B.bEpiduralbhematomasbarebusuallybseenbinbthebfrontalbregion
C.bSubduralbhematomasbarebcausedbbybinjurybtobthebmiddlebmeningealbartery
D.bSubduralbhematomasbtypicallybhavebablenticularbshapebonbCT
E.bThebassociatedbbrainbdamagebisbmorebseverebinbepiduralbhematomasb-bans-
A.bCerebralbcontusionsbmaybcoalescebtobformbanbintracerebralbhematoma
EM:bEpidural,bmiddlebmeningeal
SuB:bSubdural,bBridgingbveins
Anb18byearboldbmalebisbbroughtbtobthebEDbafterbbeingbshot.bHebhasbonebbulle
tbwoundbjustbbelowbthebrightbclaviclebandbanotherbjustbbelowbthebcostalbmargin
binbthebrightbposteriorbaxillarybline.bHisbbloodbpressurebisb110/60,bheartbratebof
b90,bandbrespiratorybratebofb34.bAfterbensuringbabpatentbairwaybandbinsertingb2
blargebcaliberbIVblines,bthebnextbmostbappropriatebstepbisbto:
A.bObtainbabportablebchestbx-ray
B.bAdministerbabbolusbofbadditionalbIVbfluid
C.bPerformbablaparatomy
D.bObtainbanbabdominalbCTbscan
E.bPerformbdiagnosticbperitonealblavageb-bans-A.bObtainbabportablebchestbx-ray
needbmorebinfobonbchest,bnotbabdomen
WhichbofbthebfollowingbshouldbbebperformedbFIRSTbinbanybpatientbwhosebinjurie
sbmaybincludebmultiplebclosedbextremitybfractures?
A.bAbthoroughbassessmentbofbfourblimbbperfusion
B.bManueversbtobpreventbnecrosisbofbthebskin
C.bExtremitybcompartmentbsyndromebrelease
D.bEnsuringbadequateboxygenationbandbventilation
E.bEvaluationbforboccultbcrushbsyndromeb-bans-
D.bEnsuringbadequateboxygenationbandbventilation
(ABC's)
, Ab22byearboldbmalebsustainsbabshotgunbwoundbtobthebshoulderbandbchestbatbc
losebrange.bHisbBPbisb80/40bandbHRb130.bAfterb2bLbofbcrystalloidbsolutionbare
brapidlybinfused,bhisbBPbincreasesbtob122/84bandbHRbdecreasesbtob100.bHebis
btachypneicbwithbRRbofb28.bOnbPE,bhisbbreathbsoundsbarebdecreasedbatbthebl
eftbupperbchestbwithbdullnessbonbpercussion.bAblargebcaliberbtubebthoracostomy
bisbinsertedbintobthebfifthbintercostalbspacebwithbthebreturnbofb200bmLbofbblood
bandbnobairbleak.bThebmostbappropriatebnextbstepbis:
A.bInsertbabfoleybcatheter
B.bBeginbtobtransfusebObnegativebblood
C.bPerformbthoracotomy
D.bObtainbabCTbChest/Abd
E.bRepeatbthebphysicalbexambofbthebchestb-bans-
E.bRepeatbthebphysicalbexambofbthebchest
decreasedbbreathbsoundsbw/dullnessb->bhemothorax,bneedbtubebtobdrain
vs.
decreased/absentbbreathbsoundsbw/hyperresonanceb-
>btensionbpneumonia,bneedbneedlebdecompressionbfollowedbbybtube
Whichbonebofbthebfollowingbstatementsbconcerningbspinebandbspinalbcordbtraum
abisbTRUE?
A.bAbnormalblateralbCbspinebfilmbexcludesbinjury
B.bAbvertebralbinjurybisbunlikelybinbthebabsencebofbphysicalbfindingsbofbabcordbi
njury
C.bAbpatientbwithbabsuspectedbspinebinjurybrequiresbimmobilizationbonbabshortbs
pine
D.bDiaphragmaticbbreathingbinbanbunconsciousbpatientbwhobhasbfallenbisbabsign
bofbspinebinjury
E.bDeterminationbofbwhetherbabspinalbcordblesionbisbcompleteborbincompletebmu
stbbebmadebinbthebprimarybsurveyb-bans-
B.bAbvertebralbinjurybisbunlikelybinbthebabsencebofbphysicalbfindingsbofbabcordbi
njury
Ab17byearboldbfemalebisbbroughtbtobthebEDbfollowingbab6bfeetbfallbontobconcre
te.bShebisbunresponsivebandbfoundbtobhavebabRRbofb32,bBPbofb90/60,bandbH
Rbofb68.bThebFIRSTbstepbinbtreatmentbis:
A.bAdministeringbvasopressors
B.bEstablishingbIVbaccessbforbdrug-assistedbintubation
C.bSeekingbthebcausebofbherbdecreasedblevelbofbconsciousness
D.bApplyingboxygenbandbmaintainingbairway
E.bExcludingbhemorrhagebasbabcausebofbshockb-bans-
D.bApplyingboxygenbandbmaintainingbairway
Firstb=bABCs
Signsbandbsymptomsbofbairwaybcompromisebincludeballbofbthebfollowingbexcept:
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Ab22byearboldbmalebisbbroughtbbybambulancebtobabsmallbcommunitybhospitalbaf
terbfallingbfrombthebtopbofbanb8bfootbladder.bInitially,bhebwasbfoundbtobhavebab
largebrightbpneumothorax.bAbchestbtubebwasbinsertedbandbconnectedbtobanbund
erwaterbsealbdrainagebcollectionbsystembwithbnegativebpressure.bAbrepeatbCXRb
demonstratesbabresidual,blargebrightbpneumothorax.bAfterbtransferringbthebpatient
btobabverifiedbtraumabcenter,babthirdbchestbx-
raybrevealsbabpersistentbrightbpneumothorax.bThebchestbtubebappearsbtobbebfun
ctioningbandbinbgoodbposition.bHebremainsbhemodynamicallybnormalbwithbnobsig
nsbofbrespiratorybdistress.bThebmostblikelybcausebforbthebpersistentbrightbpneum
othoraxbis:
A.bFlailbchest
B.bDiaphragmaticbinjury
C.bPulmonarybcontusion
D.bEsophagealbperforation
E.bTracheobronchialbinjuryb-bans-E.bTracheobronchialbinjury
WhichbofbthebfollowingbisbLEASTbreliablebforbdiagnosingbESOPHAGEALbintubatio
n?
A.bsymmetricalbchestbwallbmovement
B.bend-tidalbCO2
C.bbilateralbbreathbsounds
D.boxygenbsaturationb>92%
E.bETTbabovebcarinabonbchestbx-rayb-bans-D.boxygenbsaturationb>92%
->bifbitbsaysbESOPHAGEAL,bgobwithbthisbanswer
Whichbofbthebfollowingbsignsbnecessitatesbthebneedbforbabdefinitivebairwaybinbs
everebtraumabpatient?
,A.bfacialblacerations
B.brepeatedbvomiting
C.bseverebmaxillofacialbtrauma
D.bsternalbfracture
E.bGCSb12b-bans-C.bSeverebmaxillofacialbtrauma
Twentybsevenbpeoplebarebseverelybinjuredbinbanbaircraftbcrashbatbablocalbairport
.bThebprinciplesbofbtriagebinclude:
A.bestablishbabtriagebsitebwithinbthebinternalbperimeterbofbthebcrashbsite
B.btreatbonlybthebmostbseverelybinjuredbpatientsbfirst
C.bimmediatelybtransportballbpatientsbtobthebnearestbhospital
D.btreatbthebgreatestbnumberbofbpatientsbinbthebshortestbperiodbofbtime
E.bproducebthebgreatestbnumberbofbsurvivorsbbasedbonbavailablebresourcesb-
bans-E.bProducebthebgreatestbnumberbofbsurvivorsbbasedbonbavailablebresources
Whichbofbthebfollowingbstatementsbarebcorrect?
A.bCerebralbcontusionsbmaybcoalescebtobformbanbintracerebralbhematoma
B.bEpiduralbhematomasbarebusuallybseenbinbthebfrontalbregion
C.bSubduralbhematomasbarebcausedbbybinjurybtobthebmiddlebmeningealbartery
D.bSubduralbhematomasbtypicallybhavebablenticularbshapebonbCT
E.bThebassociatedbbrainbdamagebisbmorebseverebinbepiduralbhematomasb-bans-
A.bCerebralbcontusionsbmaybcoalescebtobformbanbintracerebralbhematoma
EM:bEpidural,bmiddlebmeningeal
SuB:bSubdural,bBridgingbveins
Anb18byearboldbmalebisbbroughtbtobthebEDbafterbbeingbshot.bHebhasbonebbulle
tbwoundbjustbbelowbthebrightbclaviclebandbanotherbjustbbelowbthebcostalbmargin
binbthebrightbposteriorbaxillarybline.bHisbbloodbpressurebisb110/60,bheartbratebof
b90,bandbrespiratorybratebofb34.bAfterbensuringbabpatentbairwaybandbinsertingb2
blargebcaliberbIVblines,bthebnextbmostbappropriatebstepbisbto:
A.bObtainbabportablebchestbx-ray
B.bAdministerbabbolusbofbadditionalbIVbfluid
C.bPerformbablaparatomy
D.bObtainbanbabdominalbCTbscan
E.bPerformbdiagnosticbperitonealblavageb-bans-A.bObtainbabportablebchestbx-ray
needbmorebinfobonbchest,bnotbabdomen
WhichbofbthebfollowingbshouldbbebperformedbFIRSTbinbanybpatientbwhosebinjurie
sbmaybincludebmultiplebclosedbextremitybfractures?
A.bAbthoroughbassessmentbofbfourblimbbperfusion
B.bManueversbtobpreventbnecrosisbofbthebskin
C.bExtremitybcompartmentbsyndromebrelease
D.bEnsuringbadequateboxygenationbandbventilation
E.bEvaluationbforboccultbcrushbsyndromeb-bans-
D.bEnsuringbadequateboxygenationbandbventilation
(ABC's)
, Ab22byearboldbmalebsustainsbabshotgunbwoundbtobthebshoulderbandbchestbatbc
losebrange.bHisbBPbisb80/40bandbHRb130.bAfterb2bLbofbcrystalloidbsolutionbare
brapidlybinfused,bhisbBPbincreasesbtob122/84bandbHRbdecreasesbtob100.bHebis
btachypneicbwithbRRbofb28.bOnbPE,bhisbbreathbsoundsbarebdecreasedbatbthebl
eftbupperbchestbwithbdullnessbonbpercussion.bAblargebcaliberbtubebthoracostomy
bisbinsertedbintobthebfifthbintercostalbspacebwithbthebreturnbofb200bmLbofbblood
bandbnobairbleak.bThebmostbappropriatebnextbstepbis:
A.bInsertbabfoleybcatheter
B.bBeginbtobtransfusebObnegativebblood
C.bPerformbthoracotomy
D.bObtainbabCTbChest/Abd
E.bRepeatbthebphysicalbexambofbthebchestb-bans-
E.bRepeatbthebphysicalbexambofbthebchest
decreasedbbreathbsoundsbw/dullnessb->bhemothorax,bneedbtubebtobdrain
vs.
decreased/absentbbreathbsoundsbw/hyperresonanceb-
>btensionbpneumonia,bneedbneedlebdecompressionbfollowedbbybtube
Whichbonebofbthebfollowingbstatementsbconcerningbspinebandbspinalbcordbtraum
abisbTRUE?
A.bAbnormalblateralbCbspinebfilmbexcludesbinjury
B.bAbvertebralbinjurybisbunlikelybinbthebabsencebofbphysicalbfindingsbofbabcordbi
njury
C.bAbpatientbwithbabsuspectedbspinebinjurybrequiresbimmobilizationbonbabshortbs
pine
D.bDiaphragmaticbbreathingbinbanbunconsciousbpatientbwhobhasbfallenbisbabsign
bofbspinebinjury
E.bDeterminationbofbwhetherbabspinalbcordblesionbisbcompleteborbincompletebmu
stbbebmadebinbthebprimarybsurveyb-bans-
B.bAbvertebralbinjurybisbunlikelybinbthebabsencebofbphysicalbfindingsbofbabcordbi
njury
Ab17byearboldbfemalebisbbroughtbtobthebEDbfollowingbab6bfeetbfallbontobconcre
te.bShebisbunresponsivebandbfoundbtobhavebabRRbofb32,bBPbofb90/60,bandbH
Rbofb68.bThebFIRSTbstepbinbtreatmentbis:
A.bAdministeringbvasopressors
B.bEstablishingbIVbaccessbforbdrug-assistedbintubation
C.bSeekingbthebcausebofbherbdecreasedblevelbofbconsciousness
D.bApplyingboxygenbandbmaintainingbairway
E.bExcludingbhemorrhagebasbabcausebofbshockb-bans-
D.bApplyingboxygenbandbmaintainingbairway
Firstb=bABCs
Signsbandbsymptomsbofbairwaybcompromisebincludeballbofbthebfollowingbexcept:
