1|Page
Absite Trauma Actual Exam Newest 2025/2026 With
Complete 200 Questions And Correct Answers
|Already Graded A+||Brand New Version!|
treatment for simple pneumo prior to laproscopy - ..........ANSWER.......A simple
pneumothorax can be aggravated to a tension pneumothorax during the positive
pressure ventilation given with general anesthesia for a diagnostic laparoscopy if a
chest tube is not placed prior to intubation.
injury to zone 2 neck - ..........ANSWER.......The injury involves zone II of the neck
(between the angle of the mandible and the cricoid cartilage) which classically has
required mandatory exploration. However, in more recent practice when there are
no hard signs of vascular injury, a CT angiography of the neck can provide detailed
cross-sectional imaging and diagnose vascular injury. Endoscopy and bronchoscopy
can be used to diagnosis tracheal and esophageal injuries when injury to these
structures is suspected based on mechanism and /or CT findings. Angiography alone
is seldom used to diagnose a vascular injury in a penetrating neck wound and
should not be part of standard practice. However, all unstable patients with
isolated penetrating neck wounds and/or patients with hard signs of vascular injury
(bruit, thrill, expanding hematoma) require operative exploration of the neck
The brown recluse spider bite - ..........ANSWER.......The brown recluse spider is
primarily located in the south central United States. After it bites a person, a papule
develops, which then progresses to a lesion with central necrosis. This lesion can be
mild or extensive and require evaluation by a plastic surgeon. The toxin of the
,2|Page
spider may lead to several hematologic abnormalities that range from a
coagulopathy to disseminated intravascular coagulation.
post esophageal repair leak - ..........ANSWER.......The patient presented has
mediastinitis and is in shock. Given his presentation, he requires antibiotics, re-
exploration via thoracotomy, wide drainage, and t-tube placement. If he had
presented without shock and with normal vital signs and a small leak, then it would
be reasonable to consider less invasive options for management. Esophagoscopy
and esophageal stent placement has been shown to be successful in patients with
small esophageal leaks that are hemodynamically normal. Percutaneous drainage
and antibiotics along should be reserved for a very select group of patients. These
patients are usually greater than 24 hours from perforation, have a small contained
leak, and are hemodynamically normal. Surgically repairing the injury again, after
it has already failed initial repair, and the patient is now in shock, should not be
considered.
IO in kids - ..........ANSWER.......Intraosseous fluid infusions to replace blood volume
loss are a standard part of the resuscitation for injured children. In the emergency
setting, with less-than-optimal lighting, assistance, and choice of equipment, the
intraosseous route does not require the precision demanded for cannulating the
small vessels of children, yet provides a cannula large enough to deliver adequate
volume. Although a number of osseous ports are feasible for this technique, the
medial aspect of the tibia, 2 or 3 cm distal to the tibial tuberosity, is the usual site
for insertion of the intraosseous needle. Colloid solutions, including blood, and
crystalloids can be infused by this route. With maintenance of proper sterile
procedures, infections associated with intraosseous punctures are not a problem. The
intraosseous route has also been used in adults and may be the best option for
,3|Page
adults who have no available peripheral veins when central vein cannulation or a
cutdown is not an appropriate choice.
traumatic diaphragm rupture - ..........ANSWER.......Biliary pleural fistula is a rare
and dreaded complication following traumatic diaphragmatic injury. The diagnosis
is made by placement of a chest tube with evacuation of bilious content. The
diagnosis can be confirmed with scintigraphy. Initial treatment includes placement of
a thoracostomy tube and decompression of the biliary tree by endoscopic
retrograde cholangiopancreatography with sphincterotomy, or placement of a
percutaneous biliary drain.
indication for operation after chest tube placement in setting of trauma -
..........ANSWER.......Massive hemothorax results from the collection of more than
1,500 mL of blood (30% to 40% of total blood volume) rapidly in the chest. This
occurs most often with a penetrating wound with a systemic or hilar vessel injury,
though it can also occur with blunt trauma. Penetrating anterior chest wounds medial
to the nipple line and posterior wounds medial to the scapula should alert to the
likelihood of an injury to the great vessels, hilar structures, and the heart. A massive
hemothorax is suspected when shock accompanies absence of breath sounds and
dullness to percussion on one side of the chest. Blood loss is complicated by hypoxia,
as the significant rapid accumulation of blood in the chest compromises respiratory
efforts by mechanically compressing the lung and preventing adequate ventilation.
Initial management includes simultaneous restoration of blood volume along with
decompression of the chest cavity with a chest tube to evacuate the blood. If
greater than 1,000 mL of blood is drained by the initial chest tube, an additional
tube should be placed to ensure better evacuation and hemostasis, and to avoid
potential problems from clot formation and occlusion of the initial tube. Traditional
, 4|Page
criteria for taking the patient to the operating room (OR) for a thoracotomy are
initial output of more than 1,500 mL of blood or continuing blood loss of 200 mL/h
for 2 to 4 hours. Need for blood transfusions to maintain blood pressure represents
hemorrhagic shock and is an indication for thoracotomy. In the OR, evacuated blood
can ideally be collected in a device capable of autotransfusion.
chest tube placement - ..........ANSWER.......The best landmarks for placement of tube
thoracostomy are those that allow for the easier, safest, and most reproducible
approach. The anterior axillary line, just behind the pectoralis muscle, is the thinnest
and anatomically simplest portion of the chest wall. It is necessary to stay anterior
to the midline to avoid the long thoracic nerve. Choice of the inframammary crease
should put the tube at approximately the level of the fifth interspace. Placement in
the fifth intercostal space also minimizes risk of inducing injury to abdominal
contents that may have herniated through a disrupted diaphragm. This will also
prevent penetration through the diaphragm cephalad. Placement of the tube
anteriorly allows ease in the direction of the tube posteriorly for optimal placement
to utilize gravity and body position to enhance drainage. Also, placement in the
anterior axillary line avoids the discomfort of patient position and direct pressure
on the chest thoracostomy site.
nutrition in burn - ..........ANSWER.......Until recently it was believed that the immense
stress response initiated by severe burns produced a paralytic ileus that would
preclude enteral feeding for several days postburn. More recent studies have
shown that enteral feeding not only can be tolerated immediately after burning, but
that paralytic ileus can actually be prevented. There is no need for gastric
decompression if ileus is not present. The risk of aspiration with early feeding is
minimal. Awake patients can protect their airway, and intubated patients usually
Absite Trauma Actual Exam Newest 2025/2026 With
Complete 200 Questions And Correct Answers
|Already Graded A+||Brand New Version!|
treatment for simple pneumo prior to laproscopy - ..........ANSWER.......A simple
pneumothorax can be aggravated to a tension pneumothorax during the positive
pressure ventilation given with general anesthesia for a diagnostic laparoscopy if a
chest tube is not placed prior to intubation.
injury to zone 2 neck - ..........ANSWER.......The injury involves zone II of the neck
(between the angle of the mandible and the cricoid cartilage) which classically has
required mandatory exploration. However, in more recent practice when there are
no hard signs of vascular injury, a CT angiography of the neck can provide detailed
cross-sectional imaging and diagnose vascular injury. Endoscopy and bronchoscopy
can be used to diagnosis tracheal and esophageal injuries when injury to these
structures is suspected based on mechanism and /or CT findings. Angiography alone
is seldom used to diagnose a vascular injury in a penetrating neck wound and
should not be part of standard practice. However, all unstable patients with
isolated penetrating neck wounds and/or patients with hard signs of vascular injury
(bruit, thrill, expanding hematoma) require operative exploration of the neck
The brown recluse spider bite - ..........ANSWER.......The brown recluse spider is
primarily located in the south central United States. After it bites a person, a papule
develops, which then progresses to a lesion with central necrosis. This lesion can be
mild or extensive and require evaluation by a plastic surgeon. The toxin of the
,2|Page
spider may lead to several hematologic abnormalities that range from a
coagulopathy to disseminated intravascular coagulation.
post esophageal repair leak - ..........ANSWER.......The patient presented has
mediastinitis and is in shock. Given his presentation, he requires antibiotics, re-
exploration via thoracotomy, wide drainage, and t-tube placement. If he had
presented without shock and with normal vital signs and a small leak, then it would
be reasonable to consider less invasive options for management. Esophagoscopy
and esophageal stent placement has been shown to be successful in patients with
small esophageal leaks that are hemodynamically normal. Percutaneous drainage
and antibiotics along should be reserved for a very select group of patients. These
patients are usually greater than 24 hours from perforation, have a small contained
leak, and are hemodynamically normal. Surgically repairing the injury again, after
it has already failed initial repair, and the patient is now in shock, should not be
considered.
IO in kids - ..........ANSWER.......Intraosseous fluid infusions to replace blood volume
loss are a standard part of the resuscitation for injured children. In the emergency
setting, with less-than-optimal lighting, assistance, and choice of equipment, the
intraosseous route does not require the precision demanded for cannulating the
small vessels of children, yet provides a cannula large enough to deliver adequate
volume. Although a number of osseous ports are feasible for this technique, the
medial aspect of the tibia, 2 or 3 cm distal to the tibial tuberosity, is the usual site
for insertion of the intraosseous needle. Colloid solutions, including blood, and
crystalloids can be infused by this route. With maintenance of proper sterile
procedures, infections associated with intraosseous punctures are not a problem. The
intraosseous route has also been used in adults and may be the best option for
,3|Page
adults who have no available peripheral veins when central vein cannulation or a
cutdown is not an appropriate choice.
traumatic diaphragm rupture - ..........ANSWER.......Biliary pleural fistula is a rare
and dreaded complication following traumatic diaphragmatic injury. The diagnosis
is made by placement of a chest tube with evacuation of bilious content. The
diagnosis can be confirmed with scintigraphy. Initial treatment includes placement of
a thoracostomy tube and decompression of the biliary tree by endoscopic
retrograde cholangiopancreatography with sphincterotomy, or placement of a
percutaneous biliary drain.
indication for operation after chest tube placement in setting of trauma -
..........ANSWER.......Massive hemothorax results from the collection of more than
1,500 mL of blood (30% to 40% of total blood volume) rapidly in the chest. This
occurs most often with a penetrating wound with a systemic or hilar vessel injury,
though it can also occur with blunt trauma. Penetrating anterior chest wounds medial
to the nipple line and posterior wounds medial to the scapula should alert to the
likelihood of an injury to the great vessels, hilar structures, and the heart. A massive
hemothorax is suspected when shock accompanies absence of breath sounds and
dullness to percussion on one side of the chest. Blood loss is complicated by hypoxia,
as the significant rapid accumulation of blood in the chest compromises respiratory
efforts by mechanically compressing the lung and preventing adequate ventilation.
Initial management includes simultaneous restoration of blood volume along with
decompression of the chest cavity with a chest tube to evacuate the blood. If
greater than 1,000 mL of blood is drained by the initial chest tube, an additional
tube should be placed to ensure better evacuation and hemostasis, and to avoid
potential problems from clot formation and occlusion of the initial tube. Traditional
, 4|Page
criteria for taking the patient to the operating room (OR) for a thoracotomy are
initial output of more than 1,500 mL of blood or continuing blood loss of 200 mL/h
for 2 to 4 hours. Need for blood transfusions to maintain blood pressure represents
hemorrhagic shock and is an indication for thoracotomy. In the OR, evacuated blood
can ideally be collected in a device capable of autotransfusion.
chest tube placement - ..........ANSWER.......The best landmarks for placement of tube
thoracostomy are those that allow for the easier, safest, and most reproducible
approach. The anterior axillary line, just behind the pectoralis muscle, is the thinnest
and anatomically simplest portion of the chest wall. It is necessary to stay anterior
to the midline to avoid the long thoracic nerve. Choice of the inframammary crease
should put the tube at approximately the level of the fifth interspace. Placement in
the fifth intercostal space also minimizes risk of inducing injury to abdominal
contents that may have herniated through a disrupted diaphragm. This will also
prevent penetration through the diaphragm cephalad. Placement of the tube
anteriorly allows ease in the direction of the tube posteriorly for optimal placement
to utilize gravity and body position to enhance drainage. Also, placement in the
anterior axillary line avoids the discomfort of patient position and direct pressure
on the chest thoracostomy site.
nutrition in burn - ..........ANSWER.......Until recently it was believed that the immense
stress response initiated by severe burns produced a paralytic ileus that would
preclude enteral feeding for several days postburn. More recent studies have
shown that enteral feeding not only can be tolerated immediately after burning, but
that paralytic ileus can actually be prevented. There is no need for gastric
decompression if ileus is not present. The risk of aspiration with early feeding is
minimal. Awake patients can protect their airway, and intubated patients usually
