ATLS EXAM QUESTIONS AND ANSWERS
100% CORRECT!(UPDATED!!!)
,True or false? Although the mechanism of injury may be similar to those for the younger
population, data shows increased mortality with similar severity of injury in older adults.
- ANSWER True
In the elderly population, what is decreased physiological reserve? - ANSWER aging is
characterized by impaired adaptive and homeostatic mechanisms that caused an
increased susceptibility to the stress of injury. Insults tolerated by the younger
population can lead to devastating results in elderly patients.
Pre-existing conditions that affect morbidity and mortality include: - ANSWER cirrhosis,
coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - ANSWER Fall. Nonfatal
falls are common in women and fractures are common in women who fall. Falls are the
most common cause of TBI.
In the elderly population, what are risk factors for falls? - ANSWER advanced age,
physical impairment, history of previous fall, medication use, dementia, unsteady gait,
and visual, cognitive impairment
Most of elderly traffic fatalities occur in the daytime and on weekends and typically
involve other vehicles. Why? - ANSWER Older people drive on more familiar roads and
at lower speeds and tend to drive during the day. Older people have slower reaction
time, a larger blind spot, limited cervical mobility, decreased hearing, and cognitive
impairment.
True or False? Mortality associated with small to moderate sized burns in older adults
remains high - ANSWER True
Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an
adequate number of hair follicles, will result in a full thickness burn in older patients. -
ANSWER this is true
Airway-patients may have dentures that may loosen or obstruct the airway. If dentures
are not obstructing the airway, leave them in place for what? - ANSWER bag mask
ventilation, as it improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos, barbiturates, and
other sedatives should be reduced to what percentage to minimize the risk of
cardiovascular depression? - ANSWER 20-40%
, Functional changes in renal system include loss of renal mass, decreased GFR, and
decreased sensitivity to ADH and aldosterone - ANSWER resulting in drug dosing for
renal insufficiency, decreased ability to concentrate urine, increased risk for AKI and
urine flow may be normal with hypovolemia
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in
joints and cartilage, c spine degenerative changes and loss of skin elastin and
subcutaneous fat - ANSWER resulting in increased risk for fractures, decreased
mobility, difficulty for oral intubation, risk of skin injury, increased risk for hypothermia,
challenges in rehabiliation
Functional changes in Endocrine system include decreased production and response to
thyroxin and decreased dehydroepiandrosterone (DHEA) - ANSWER resulting in occult
hypothyroidism, relative hypercortisone states and increased risk of infection
True or false: Arthritis can complicate the airway and cervical spine. Patients can have
multilevel degenerative changes affecting disk spaces and posterior elements
associated with severe central canal stenosis, cord compression, and myelomalacia -
ANSWER true
In elderly population, due to their changes in pulmonary system, placing a gauze
between gums and cheek to achieve seal when using bag valve mask ventilation is
okay. In addition, because aging causes a suppressed heart rate response to
hypoxia...... - ANSWER respiratory failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at
significant risk for being inaccurately categorized as hemodynamically stable. -
ANSWER Elderly patients have a fixed heart rate and fixed cardiac output, thus, their
response to hypovolemia will involve increasing their systemic vascular resistance.
Furthermore, since older patients have HTN, an acceptable BP may truly reflect a
hypotensive state. A systolic BP of 110 is to be utilized as the threshold for identifying
hypotension in patients 65 and older.
Do no equate blood pressure with shock in older patients - ANSWER BP in older
patients may look normal due to the medications they are on. Use lactate and base
deficit to evaluate for evidence of shock
what 2 factors place elderly patients at risk for intracranial hemorrhage? - ANSWER
aging causes dura to become more adherent to the skull increasing risk of injury and
older patients are on anticoagulant and antiplatelet medications.
100% CORRECT!(UPDATED!!!)
,True or false? Although the mechanism of injury may be similar to those for the younger
population, data shows increased mortality with similar severity of injury in older adults.
- ANSWER True
In the elderly population, what is decreased physiological reserve? - ANSWER aging is
characterized by impaired adaptive and homeostatic mechanisms that caused an
increased susceptibility to the stress of injury. Insults tolerated by the younger
population can lead to devastating results in elderly patients.
Pre-existing conditions that affect morbidity and mortality include: - ANSWER cirrhosis,
coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - ANSWER Fall. Nonfatal
falls are common in women and fractures are common in women who fall. Falls are the
most common cause of TBI.
In the elderly population, what are risk factors for falls? - ANSWER advanced age,
physical impairment, history of previous fall, medication use, dementia, unsteady gait,
and visual, cognitive impairment
Most of elderly traffic fatalities occur in the daytime and on weekends and typically
involve other vehicles. Why? - ANSWER Older people drive on more familiar roads and
at lower speeds and tend to drive during the day. Older people have slower reaction
time, a larger blind spot, limited cervical mobility, decreased hearing, and cognitive
impairment.
True or False? Mortality associated with small to moderate sized burns in older adults
remains high - ANSWER True
Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an
adequate number of hair follicles, will result in a full thickness burn in older patients. -
ANSWER this is true
Airway-patients may have dentures that may loosen or obstruct the airway. If dentures
are not obstructing the airway, leave them in place for what? - ANSWER bag mask
ventilation, as it improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos, barbiturates, and
other sedatives should be reduced to what percentage to minimize the risk of
cardiovascular depression? - ANSWER 20-40%
, Functional changes in renal system include loss of renal mass, decreased GFR, and
decreased sensitivity to ADH and aldosterone - ANSWER resulting in drug dosing for
renal insufficiency, decreased ability to concentrate urine, increased risk for AKI and
urine flow may be normal with hypovolemia
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in
joints and cartilage, c spine degenerative changes and loss of skin elastin and
subcutaneous fat - ANSWER resulting in increased risk for fractures, decreased
mobility, difficulty for oral intubation, risk of skin injury, increased risk for hypothermia,
challenges in rehabiliation
Functional changes in Endocrine system include decreased production and response to
thyroxin and decreased dehydroepiandrosterone (DHEA) - ANSWER resulting in occult
hypothyroidism, relative hypercortisone states and increased risk of infection
True or false: Arthritis can complicate the airway and cervical spine. Patients can have
multilevel degenerative changes affecting disk spaces and posterior elements
associated with severe central canal stenosis, cord compression, and myelomalacia -
ANSWER true
In elderly population, due to their changes in pulmonary system, placing a gauze
between gums and cheek to achieve seal when using bag valve mask ventilation is
okay. In addition, because aging causes a suppressed heart rate response to
hypoxia...... - ANSWER respiratory failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at
significant risk for being inaccurately categorized as hemodynamically stable. -
ANSWER Elderly patients have a fixed heart rate and fixed cardiac output, thus, their
response to hypovolemia will involve increasing their systemic vascular resistance.
Furthermore, since older patients have HTN, an acceptable BP may truly reflect a
hypotensive state. A systolic BP of 110 is to be utilized as the threshold for identifying
hypotension in patients 65 and older.
Do no equate blood pressure with shock in older patients - ANSWER BP in older
patients may look normal due to the medications they are on. Use lactate and base
deficit to evaluate for evidence of shock
what 2 factors place elderly patients at risk for intracranial hemorrhage? - ANSWER
aging causes dura to become more adherent to the skull increasing risk of injury and
older patients are on anticoagulant and antiplatelet medications.
