ATLS QUESTIONS AND ANSWERS
1. 25 yo woman within the third trimester of preganacy is introduced to the ED following a
high pace MVA. She is aware, and her crucial signs and symptoms are RR sixteen, HR a
hundred and twenty, BP 70/50. The laboratory effects display a PaCO2 of
50mmHg/5.3kPa (normal variety 35-forty five). Which one of the following statments
concerning this affected person is genuine?
A. Fetal assessment have to take precedence
b. Logrolling the affected person to the right will decompress the vena cava
c. Rh immuno remedy sshould be without delay adminstered
d. Everyday PaCO2 is concerning for forthcoming RR
e. Vasopressors ought to be given to the affected person - ANSWER-d. Normal PaCO2
is regarding for forthcoming RR
2. 30 yr antique male gift with a stab wound to the stomach. BP is 60/34, HR a hundred
thirty, RR 25 and GCS 13 E3V4M6. Neck veins are flat and chest exam is apparent with
bilateral breath sounds. Optimal resuscitation should encompass:
A. Transfusion of FFP and platelets
B. 500ml of hypertonic saline and transfusion of pRBCs
C. Resuscitation with crystalloid and pRBC until base excess is regular
D. Fluid resuscitation and angioembolization
E. Preparation for laparotomy while beginning fluid resuscitation - ANSWER-E.
Preparation for laparotomy at the same time as starting up fluid resuscitation
3. A 14 12 months vintage female is brought to the ED after falling from a horse. Cervical
spinal movement is constrained wit ha tough collar and cervical blocks and she or he is
immobilized on an extended backbone board. Which of the subsequent IS TRUE
REGARDING Cervical backbone x-ray:
A. More than 20% of these sufferers will have cervical spine harm
B. Cervical backbone damage is excluded if no abnormalities are determined on lateral
cervical backbone xray
C. Are not needed if she is conscious, alert, neurologically ordinary, and has no neck
ache or midline tenderness
D. Should be done earlier than adressing capability breating or circulatory problems
E. She need to reamin on teh lengthy spine board until imaging excluded injuries -
ANSWER-C. Are not wished if she is awake, alert, neurologically ordinary, and has
no neck ache or midline tenderness
4. A 15 yr old is delivered to the ED after being concerned in a MVA. He turned into
intubated by means of emergency clinical personnal with next bilateral breath sounds
consistent with their record. Upon arrival to the ED the sufferers O2 saat is ninety two%,
coronary heart ninety six, and blood strain 150/eighty five. Breath sounds are reduced
inside the left aspect of the thorax. The subsequent step is
a. On the spot needle cricothyroidotomy
b. On the spot needle thoracentesis
, c. Chest tube insertion
d. Re-examine the placement of the endotracheal tube
e. Gain a chest CT - ANSWER-d. Reassess the placement of the endotracheal tube
5. A 15 yr antique male present following a motorcycle crash. INitial examinations reveals
ordinary crucial signs. There is a massive bruise over his epigastrium that extends to the
left flank. He has no other apparent accidents. A CT-experiment of the abdomen show a
ruptured spleen surrounded by using a massive hematoma and fluid inside the pelvis.
The next step within the patients management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical seek advice from
E. Transfer to a pediatrician - ANSWER-D. Surgical consult
6. A 22 12 months antique male gift following a bike crash. He complains of the lack of
ability to move his legs. His BP is eighty/50, HR 70, RR 18 and GCS 15. Oxygen
saturation is 99% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are everyday.
Extremities are ordinary. His management have to be:
A: 1L of iv . Crystalloid and devices of pRBCs
B. 1L of iv. Crystalloid, mannitol and iv steroids
C. 1 unit of albumin and compression stockings
D. Vasopressors and laparotomy
E. 1 L of cystalloid and vasopressors if blood stress does no longer respond -
ANSWER-E. 1 L of cystalloid and vasopressors if blood pressure does now not
reply
7. A 22 12 months old male sustains a shotgun wound to the left shoulder and chest at
close range. His BP is 80/40mmHg and his HR is 130bpm. Fluid resusciation is initiated,
his BP increases to 122/eighty four, and HR decreases to 100bpm. He is tachypneic with
RR of 28. On physical examination, his breath sounds are reduced on the left upper
chest with dullness on percussion. A tube thoracostomy is inserted within the fifth
intercostal space with the go back of 200ml of blood and no air leak. The maximum
suitable subsequent step is to:
a. Degree blood strain again
b. Start transfuse O poor blood
c. Wait until the chest xray is completed
d. Achieve a CT test of the chest and abdomen
e. Repeat the bodily examination of the chest - ANSWER-e. Repeat the physical exam
of the chest
8. A 22 yo male is brought to the ED after being assaulted in a bar. On intial exam, his
critical signs are ordinary and his Glasgow Coma scale is V5E4M6. A specific indication
for a head CT is
a. Prescence of hemotympanum
b. Complains of headache
c. Prescense of 10cm scapl laceration
d. Prescence of mandibular fracture
1. 25 yo woman within the third trimester of preganacy is introduced to the ED following a
high pace MVA. She is aware, and her crucial signs and symptoms are RR sixteen, HR a
hundred and twenty, BP 70/50. The laboratory effects display a PaCO2 of
50mmHg/5.3kPa (normal variety 35-forty five). Which one of the following statments
concerning this affected person is genuine?
A. Fetal assessment have to take precedence
b. Logrolling the affected person to the right will decompress the vena cava
c. Rh immuno remedy sshould be without delay adminstered
d. Everyday PaCO2 is concerning for forthcoming RR
e. Vasopressors ought to be given to the affected person - ANSWER-d. Normal PaCO2
is regarding for forthcoming RR
2. 30 yr antique male gift with a stab wound to the stomach. BP is 60/34, HR a hundred
thirty, RR 25 and GCS 13 E3V4M6. Neck veins are flat and chest exam is apparent with
bilateral breath sounds. Optimal resuscitation should encompass:
A. Transfusion of FFP and platelets
B. 500ml of hypertonic saline and transfusion of pRBCs
C. Resuscitation with crystalloid and pRBC until base excess is regular
D. Fluid resuscitation and angioembolization
E. Preparation for laparotomy while beginning fluid resuscitation - ANSWER-E.
Preparation for laparotomy at the same time as starting up fluid resuscitation
3. A 14 12 months vintage female is brought to the ED after falling from a horse. Cervical
spinal movement is constrained wit ha tough collar and cervical blocks and she or he is
immobilized on an extended backbone board. Which of the subsequent IS TRUE
REGARDING Cervical backbone x-ray:
A. More than 20% of these sufferers will have cervical spine harm
B. Cervical backbone damage is excluded if no abnormalities are determined on lateral
cervical backbone xray
C. Are not needed if she is conscious, alert, neurologically ordinary, and has no neck
ache or midline tenderness
D. Should be done earlier than adressing capability breating or circulatory problems
E. She need to reamin on teh lengthy spine board until imaging excluded injuries -
ANSWER-C. Are not wished if she is awake, alert, neurologically ordinary, and has
no neck ache or midline tenderness
4. A 15 yr old is delivered to the ED after being concerned in a MVA. He turned into
intubated by means of emergency clinical personnal with next bilateral breath sounds
consistent with their record. Upon arrival to the ED the sufferers O2 saat is ninety two%,
coronary heart ninety six, and blood strain 150/eighty five. Breath sounds are reduced
inside the left aspect of the thorax. The subsequent step is
a. On the spot needle cricothyroidotomy
b. On the spot needle thoracentesis
, c. Chest tube insertion
d. Re-examine the placement of the endotracheal tube
e. Gain a chest CT - ANSWER-d. Reassess the placement of the endotracheal tube
5. A 15 yr antique male present following a motorcycle crash. INitial examinations reveals
ordinary crucial signs. There is a massive bruise over his epigastrium that extends to the
left flank. He has no other apparent accidents. A CT-experiment of the abdomen show a
ruptured spleen surrounded by using a massive hematoma and fluid inside the pelvis.
The next step within the patients management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical seek advice from
E. Transfer to a pediatrician - ANSWER-D. Surgical consult
6. A 22 12 months antique male gift following a bike crash. He complains of the lack of
ability to move his legs. His BP is eighty/50, HR 70, RR 18 and GCS 15. Oxygen
saturation is 99% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are everyday.
Extremities are ordinary. His management have to be:
A: 1L of iv . Crystalloid and devices of pRBCs
B. 1L of iv. Crystalloid, mannitol and iv steroids
C. 1 unit of albumin and compression stockings
D. Vasopressors and laparotomy
E. 1 L of cystalloid and vasopressors if blood stress does no longer respond -
ANSWER-E. 1 L of cystalloid and vasopressors if blood pressure does now not
reply
7. A 22 12 months old male sustains a shotgun wound to the left shoulder and chest at
close range. His BP is 80/40mmHg and his HR is 130bpm. Fluid resusciation is initiated,
his BP increases to 122/eighty four, and HR decreases to 100bpm. He is tachypneic with
RR of 28. On physical examination, his breath sounds are reduced on the left upper
chest with dullness on percussion. A tube thoracostomy is inserted within the fifth
intercostal space with the go back of 200ml of blood and no air leak. The maximum
suitable subsequent step is to:
a. Degree blood strain again
b. Start transfuse O poor blood
c. Wait until the chest xray is completed
d. Achieve a CT test of the chest and abdomen
e. Repeat the bodily examination of the chest - ANSWER-e. Repeat the physical exam
of the chest
8. A 22 yo male is brought to the ED after being assaulted in a bar. On intial exam, his
critical signs are ordinary and his Glasgow Coma scale is V5E4M6. A specific indication
for a head CT is
a. Prescence of hemotympanum
b. Complains of headache
c. Prescense of 10cm scapl laceration
d. Prescence of mandibular fracture
