ATLS Written Review test questions with
correct answers
_______ fills the space between the arachnoid and pia mater? - CORRECT ANSWERS-CSF.
this cushions the brain and spinal cord.
A GCS of ___ is accepted definition of coma? - CORRECT ANSWERS-8 or less
A local area of frost bite should be rewarmed with what temperature and in what waY? -
CORRECT ANSWERS-40C (104F)
should be done in whirlpool. not dry heat.
A midline shift of _____mm or greater on the CT is indicative of need for neurosurgery to
evacuate the clot or contusion causing the shift - CORRECT ANSWERS-5mm
After administration of mannitol what should be monitored closely? - CORRECT ANSWERS-
ICP! mannitol has a substantial rebound effect on ICP
After managing ABCDEs of TBI what MUST be identified if present? How is this done? -
CORRECT ANSWERS-mass lesion that requires surgical evacuation is critical! this is done with
CT. NOTE: obtaining a CT should not delay patient transfer to trauma center.
An 18-year-old man is brought to the hospital after smashing his motorcycle into a tree. He is
conscious us and alert, but paralyzed in both arms and legs. His skin is pale and cold. He
complains of thirst and difficulty in breathing. His airway is clear. His blood pressure is 60/40
and his pulse rate is 140 beats per minute. Breath sounds are full and equal bilaterally. He
should be treated for what first? - CORRECT ANSWERS-hypovolemic shock with fluids.
NOTE: airway is OK because he is talking even though he complains of trouble breathing.
,At what age do cervical spine differences begin to normalize? at what age does cervical spine
look like that of an adult? - CORRECT ANSWERS-marked differences in cervical spine occur
until age 8 and steadily decline until age 12 when they are similar
At what levels do the spinal cord begin and end? - CORRECT ANSWERS-begins at foramen
magnum at terminal end of the medulla oblongata and end at L1
average ICP is _____ mmHg. - CORRECT ANSWERS-10
Basilar fractures of the skull usually require what type of imaging? - CORRECT ANSWERS-this
requires CT with bone-window setting.
Carboxyhemoglobin levels greater than ___% in burn patient indicate inhalation injury and
require transport and/or intubation if transport is prolonged. - CORRECT ANSWERS-10%
Chest tube is indicated for which of the following?
-tension pneumo
-hemothorax
-ruptured bronchus
-pulmonary contusion
-mass hemothorax - CORRECT ANSWERS-All EXCEPT pulmonary contusion
Compare the specificity and sensitivity of DPL and CT in blunt abdominal trauma. - CORRECT
ANSWERS-DPL- high sens (98), low spec
CT - high sens (92-98), high spec (95)
Contusion occur in ___% of TBI. They often occur in _____ or ______ lobes of brain. They may
coalesce to form ______ in as many as 20$%. - CORRECT ANSWERS-20-30%
frontal or temporal
intracerebral hematoma.
Does hypertonic saline lower ICP in hypovolemia?
, Does mannitol lower ICP in hypovolemia? - CORRECT ANSWERS-No
NO
does weakness occur on the same or opposite side of the uncal herniation? - CORRECT
ANSWERS-OPPOSITE. the corticospinal tract of the midbrain is compressed and then crosses
at the foramen magnum.
Epidural hematomas often occur in the _____ area of the skull and result from a tear of the
_______ arteries. - CORRECT ANSWERS-temporal
middle meningeal artery
Fluid resuscitation of an infant begins with _______(amount and type). And then progresses to
______. (amount and type) - CORRECT ANSWERS-20mL/kg Ringers lactate.
(may give up to three of these boluses initially)
For the third bolus consider PRBCs at 10mL/kg
For a patient bleed profusely from a wound not he medial thigh where should pressure be
applied? - CORRECT ANSWERS-pressure should b applied directly to the wound. Do not apply
pressure to the proximal femoral artery at the groin
For a patient who is not breathing what intervention is indicated? - CORRECT ANSWERS-
orotracheal intubation
for a penetrating object such as an arrow or screw driver into the skull, test should be performed
and what should be done with the object? - CORRECT ANSWERS-need CT, Xray for trajectory,
and angiography. leave the object in place. Removing the object lead to fatal vascular injury.
For a trauma patient that requires a chest tube, the tube is placed and 1600mL of blood returns.
What is the next step in management? - CORRECT ANSWERS-prepare for exploratory
thoracotomy
How can one determine the appropriate tube depth for pediatric intubation? - CORRECT
ANSWERS-ETT tube size x 3
Ex: 4.0 ETT would be properly positioned at 12 cm from the gums
correct answers
_______ fills the space between the arachnoid and pia mater? - CORRECT ANSWERS-CSF.
this cushions the brain and spinal cord.
A GCS of ___ is accepted definition of coma? - CORRECT ANSWERS-8 or less
A local area of frost bite should be rewarmed with what temperature and in what waY? -
CORRECT ANSWERS-40C (104F)
should be done in whirlpool. not dry heat.
A midline shift of _____mm or greater on the CT is indicative of need for neurosurgery to
evacuate the clot or contusion causing the shift - CORRECT ANSWERS-5mm
After administration of mannitol what should be monitored closely? - CORRECT ANSWERS-
ICP! mannitol has a substantial rebound effect on ICP
After managing ABCDEs of TBI what MUST be identified if present? How is this done? -
CORRECT ANSWERS-mass lesion that requires surgical evacuation is critical! this is done with
CT. NOTE: obtaining a CT should not delay patient transfer to trauma center.
An 18-year-old man is brought to the hospital after smashing his motorcycle into a tree. He is
conscious us and alert, but paralyzed in both arms and legs. His skin is pale and cold. He
complains of thirst and difficulty in breathing. His airway is clear. His blood pressure is 60/40
and his pulse rate is 140 beats per minute. Breath sounds are full and equal bilaterally. He
should be treated for what first? - CORRECT ANSWERS-hypovolemic shock with fluids.
NOTE: airway is OK because he is talking even though he complains of trouble breathing.
,At what age do cervical spine differences begin to normalize? at what age does cervical spine
look like that of an adult? - CORRECT ANSWERS-marked differences in cervical spine occur
until age 8 and steadily decline until age 12 when they are similar
At what levels do the spinal cord begin and end? - CORRECT ANSWERS-begins at foramen
magnum at terminal end of the medulla oblongata and end at L1
average ICP is _____ mmHg. - CORRECT ANSWERS-10
Basilar fractures of the skull usually require what type of imaging? - CORRECT ANSWERS-this
requires CT with bone-window setting.
Carboxyhemoglobin levels greater than ___% in burn patient indicate inhalation injury and
require transport and/or intubation if transport is prolonged. - CORRECT ANSWERS-10%
Chest tube is indicated for which of the following?
-tension pneumo
-hemothorax
-ruptured bronchus
-pulmonary contusion
-mass hemothorax - CORRECT ANSWERS-All EXCEPT pulmonary contusion
Compare the specificity and sensitivity of DPL and CT in blunt abdominal trauma. - CORRECT
ANSWERS-DPL- high sens (98), low spec
CT - high sens (92-98), high spec (95)
Contusion occur in ___% of TBI. They often occur in _____ or ______ lobes of brain. They may
coalesce to form ______ in as many as 20$%. - CORRECT ANSWERS-20-30%
frontal or temporal
intracerebral hematoma.
Does hypertonic saline lower ICP in hypovolemia?
, Does mannitol lower ICP in hypovolemia? - CORRECT ANSWERS-No
NO
does weakness occur on the same or opposite side of the uncal herniation? - CORRECT
ANSWERS-OPPOSITE. the corticospinal tract of the midbrain is compressed and then crosses
at the foramen magnum.
Epidural hematomas often occur in the _____ area of the skull and result from a tear of the
_______ arteries. - CORRECT ANSWERS-temporal
middle meningeal artery
Fluid resuscitation of an infant begins with _______(amount and type). And then progresses to
______. (amount and type) - CORRECT ANSWERS-20mL/kg Ringers lactate.
(may give up to three of these boluses initially)
For the third bolus consider PRBCs at 10mL/kg
For a patient bleed profusely from a wound not he medial thigh where should pressure be
applied? - CORRECT ANSWERS-pressure should b applied directly to the wound. Do not apply
pressure to the proximal femoral artery at the groin
For a patient who is not breathing what intervention is indicated? - CORRECT ANSWERS-
orotracheal intubation
for a penetrating object such as an arrow or screw driver into the skull, test should be performed
and what should be done with the object? - CORRECT ANSWERS-need CT, Xray for trajectory,
and angiography. leave the object in place. Removing the object lead to fatal vascular injury.
For a trauma patient that requires a chest tube, the tube is placed and 1600mL of blood returns.
What is the next step in management? - CORRECT ANSWERS-prepare for exploratory
thoracotomy
How can one determine the appropriate tube depth for pediatric intubation? - CORRECT
ANSWERS-ETT tube size x 3
Ex: 4.0 ETT would be properly positioned at 12 cm from the gums
