TCRN Exam Question And Answers 2025
Kehr's sign - correct answers ✅✅Referred left shoulder pain,
usually indicates a splenic injury
Base deficit - correct answers ✅✅Base deficit more than -6
indicates the need for agressive resuscitation and determination
of the etiology
CXR - correct answers ✅✅Most important tool providing useful
information in the early minutes. Can identify major sources of
blood loss from injuries in the chest or elevated diaphragm with
displacement of abdominal organs
Tracheobronchial injury - correct answers ✅✅Should be
suspected if after chest tube placement a significant air leak is
present
Diagnostic Peritoneal Lavage - correct answers ✅✅Alternative to
FAST scan to detect abd bleeding. A urinary catheter and gastric
tube should be in place prior to procedure.
FAST - correct answers ✅✅Focused Assessment with Sonography
in Trauma. Used to detect free fluid in peritoneum or
hemoperitoneum. Free fluid appears "black" on the screen. Has
replaced DPL when available.
Positive FAST scan - correct answers ✅✅Hemodynamically
unstable trauma patient with a positive fast are taken directly to
the OR for laparotomy
,TCRN Exam Question And Answers 2025
Ultrasound abd exam - correct answers ✅✅Not useful to detect
injuries to the diaphragm, intestine and pancreas. In patients with
obesity, ascites and/or subQ emphysema the accuracy is reduced.
CT scan - correct answers ✅✅Hemodynamically stable patients
may be taken to CT
Angiography - correct answers ✅✅Embolization is useful in
treating patient with unstable pelvic fractures, liver and splenic
hemorrhage. Use of hybrid OR suites to allow for surgical and
interventional radiology methods of treatment simultaneously.
Diagnostic laparoscopy - correct answers ✅✅Can be used to
detect or exclude finding so f hemoperitoneum, organ injury,
intestinal spillage or peritoneal penetration. Most useful in
evaluating possible diaphragmatic injuries, espectially in
penetrating thoracoabdominal injuries on the left site
Diaphragmatic injuries - correct answers ✅✅Usually resultant of
penetrating throacoabdominal injuries on the left side, including
11-12 rib fractures on the left.
Small intestine injuries - correct answers ✅✅Result from
shearing forces in MVC or direct blows that crush intestine
between force and the vertebrae. Most commonly intra-abd injury
in penetrating trauma. Occurs often with spinal injury.
Pancreatic/solid organ injury are predictive of increased risk for
hollow viscus injury. Signs of peritonitis develop. Any blow to the
abd/penetrating injury to the lower chest/abd should increase
suspicion of injury
, TCRN Exam Question And Answers 2025
Treatment of small intestine injury - correct answers ✅✅Control
bleeding prior to exploration. Debridement and closure and
ligation of bleeders. Resection for multiple defects. Observe for
wound infection/abscess development
Cause of duodenum injuries - correct answers ✅✅Penetrating
trauma most frequent cause. Usually conconcurrent mult-organ
injuries. Usually found intraoperatively, commonly missed during
exlap. Blunt force injury cause by vetebral compression.
Duodenal injury treatment - correct answers ✅✅Identification
with CT scan. Commonly patients have midepigastric or back pain
with evolving peritoneal signs 6-24 hrs after injury. Primary
closure in OR, closed drainage system. Goals are to control
hemorrhage, debride devitalized tissue and provide drainage. Non
operative management requires close observation for expanding
or ruptured hematomas causing bleeding or peritoneal
contamination.
Jejunum and ileum injuries - correct answers ✅✅Jejunum lies in
umbilical region, ileum lies in the hypogastric/pelvice regions. Lap
belt can cause bowel to be crushed between the vertebrae and a
solid object. Incorrect wearing of seatbelt increases chance for
injury
Stomach injury - correct answers ✅✅Rare, more common in
children. Penetrating trauma most common cause. May find free
air on cxr/fua. Pain to epigastric/abd area, tenderness, signs of
peritonitis. Bloody output from gastric tube. Surgical intervention,
Kehr's sign - correct answers ✅✅Referred left shoulder pain,
usually indicates a splenic injury
Base deficit - correct answers ✅✅Base deficit more than -6
indicates the need for agressive resuscitation and determination
of the etiology
CXR - correct answers ✅✅Most important tool providing useful
information in the early minutes. Can identify major sources of
blood loss from injuries in the chest or elevated diaphragm with
displacement of abdominal organs
Tracheobronchial injury - correct answers ✅✅Should be
suspected if after chest tube placement a significant air leak is
present
Diagnostic Peritoneal Lavage - correct answers ✅✅Alternative to
FAST scan to detect abd bleeding. A urinary catheter and gastric
tube should be in place prior to procedure.
FAST - correct answers ✅✅Focused Assessment with Sonography
in Trauma. Used to detect free fluid in peritoneum or
hemoperitoneum. Free fluid appears "black" on the screen. Has
replaced DPL when available.
Positive FAST scan - correct answers ✅✅Hemodynamically
unstable trauma patient with a positive fast are taken directly to
the OR for laparotomy
,TCRN Exam Question And Answers 2025
Ultrasound abd exam - correct answers ✅✅Not useful to detect
injuries to the diaphragm, intestine and pancreas. In patients with
obesity, ascites and/or subQ emphysema the accuracy is reduced.
CT scan - correct answers ✅✅Hemodynamically stable patients
may be taken to CT
Angiography - correct answers ✅✅Embolization is useful in
treating patient with unstable pelvic fractures, liver and splenic
hemorrhage. Use of hybrid OR suites to allow for surgical and
interventional radiology methods of treatment simultaneously.
Diagnostic laparoscopy - correct answers ✅✅Can be used to
detect or exclude finding so f hemoperitoneum, organ injury,
intestinal spillage or peritoneal penetration. Most useful in
evaluating possible diaphragmatic injuries, espectially in
penetrating thoracoabdominal injuries on the left site
Diaphragmatic injuries - correct answers ✅✅Usually resultant of
penetrating throacoabdominal injuries on the left side, including
11-12 rib fractures on the left.
Small intestine injuries - correct answers ✅✅Result from
shearing forces in MVC or direct blows that crush intestine
between force and the vertebrae. Most commonly intra-abd injury
in penetrating trauma. Occurs often with spinal injury.
Pancreatic/solid organ injury are predictive of increased risk for
hollow viscus injury. Signs of peritonitis develop. Any blow to the
abd/penetrating injury to the lower chest/abd should increase
suspicion of injury
, TCRN Exam Question And Answers 2025
Treatment of small intestine injury - correct answers ✅✅Control
bleeding prior to exploration. Debridement and closure and
ligation of bleeders. Resection for multiple defects. Observe for
wound infection/abscess development
Cause of duodenum injuries - correct answers ✅✅Penetrating
trauma most frequent cause. Usually conconcurrent mult-organ
injuries. Usually found intraoperatively, commonly missed during
exlap. Blunt force injury cause by vetebral compression.
Duodenal injury treatment - correct answers ✅✅Identification
with CT scan. Commonly patients have midepigastric or back pain
with evolving peritoneal signs 6-24 hrs after injury. Primary
closure in OR, closed drainage system. Goals are to control
hemorrhage, debride devitalized tissue and provide drainage. Non
operative management requires close observation for expanding
or ruptured hematomas causing bleeding or peritoneal
contamination.
Jejunum and ileum injuries - correct answers ✅✅Jejunum lies in
umbilical region, ileum lies in the hypogastric/pelvice regions. Lap
belt can cause bowel to be crushed between the vertebrae and a
solid object. Incorrect wearing of seatbelt increases chance for
injury
Stomach injury - correct answers ✅✅Rare, more common in
children. Penetrating trauma most common cause. May find free
air on cxr/fua. Pain to epigastric/abd area, tenderness, signs of
peritonitis. Bloody output from gastric tube. Surgical intervention,
