ABSITE - TRAUMA – QUESTIONS WITH
CORRECT ANSWERS 2025
A 34-year-old female presents after a high-
velocity MVC with right flank pain and frank bright red blood in her urine. Her primary survey is intact
, and vital signs are HR 112 bpm, BP 86/59 mmHg, RR 20/min, and oxygen saturation is 98% on room
air. CT scan demonstrates a Grade IV laceration to the right kidney. The best choice for management is
:
A. Renorrhaphy
B. Packing of the renal fossa, temporary abdominal closure, and return to the ICU.
C. Total nephrectomy
D. Observation in the intensive care unit with blood transfusion as needed
E. Gelfoam angioembolization - CORRECT ANSWER -Renorrhaphy
Correct.
This patient is hemodynamically unstable, and therefore should be taken to the operating room for lap
arotomy and renal exploration. Principles of operative repair for a Grade IV, and for some Grade V kid
ney lacerations include renal preservation, when possible—debridement of non-
viable tissue, hemostasis using absorbable sutures in a figure-of-
eight fashion with care taken to preserve arterial supply to distal segments, closure of the collecting sy
stem with absorbable suture in a running fashion, and reapproximation of the capsule. An omental fla
p can be substituted for large defects if necessary. Damage control laparotomy is not indicated in this
patient in the absence of coagulopathy, hypothermia, or acidosis.
A 19-year-
old male presents to the emergency room after a motorcycle crash. Digital rectal exam including the p
rostate is normal, and there is no blood at the urethral meatus. He has a lateral compression pelvis fra
cture and gross hematuria. The appropriate evaluation for this patient would include:
A. Retrograde cystogram
B. Retrograde cystogram and contrast CT scan of the abdomen and pelvis
C. Contrast CT scan of the abdomen and pelvis
D. Retrograde urethrogram - CORRECT ANSWER -
Retrograde cystogram and contrast CT scan of the abdomen and pelvis
Correct.
The combination of a cystogram and a contrast CT scan of the abdomen and pelvis will diagnose pote
ntial bladder and renal injuries. No retrograde urethrogram (D) is needed as the patient did not have a
, high-
riding Dprostate Don Ddigital Drectal Dexam Dand Ddid Dnot Dhave Dblood Dat Dthe Durethral Dmeatus. DA
Dcystogram Dalon D e D (A) D would D not D evaluate D for D renal D injuries D which D are D possible D with D the
D given D mechanism D and D hematuri
a. D A D CT D scan D alone D (C) D would D not D evaluate D for D a D potential D bladder D injury D which D is D possible
D with D the D give Dn Dmechanism Dand Dhematuria.
A D 30-year-
old Dman Dpresents Dto Dthe DEmergency DDepartment Dafter Dbeing Dstruck Dby Da Dmotor Dvehicle; Dhe Dwas
Dfound Dp Dinned Dunder Dthe Dvehicle Dand Drequired D30 Dminutes Dof Dextrication. DOn Darrival, Dhis Dblood
Dpressure Dis D76/50 DmmHg, Dpulse D132 Dbeats/min, Dand Dhe Dis Dslow Dto Drespond Dto Dstimuli. DA Dmassive
Dtransfusion Dprotocol Dis Din Ditiated. DThe DFAST Dscan Dis Dpositive. DOn Dexploration, Dhe Dhas Da Dlarge Dzone
DI Dretroperitoneal Dhematoma, Da Dla Drge Dvolume Dof Dfree Dintraperitoneal Dblood, Dseveral Dsmall Dbowel
Dlacerations, Dand Da Dgrade DIII Dliver Dlaceratio
n. DAfter Dpacking Dthe Dfour Dquadrants, Dexploration Dof Dthe Dhematoma Ddemonstrates Dcomplete
Dtransection D of Dthe Dvena Dcava Dbelow Dthe Drenal Dveins. DThe Dpatient Dremains Dhemodynamically
Dunstable Ddespite Dtransfu Dsion. DWhat Dis Dyour Dnext Dstep Din Dmanagement Dof Dthe Dvena Dcaval Dinjury?
A. Perform Da Dright D medial Dvisceral Drotation, D apply D clamps D proximally D and Ddistally D on Dthe D cava,
D and Drepai D r Dthe Dinjury Dprimarily.
B. Insert Da D- DCORRECT DANSWER D-Perform Da Dright Dmedial Dvisceral Drotation Dand Dligate Dthe
D vena Dcava. DCorrect.
In Dthe Dsetting Dof Dan Dunstable Dpatient Dwith Dcomplete Dtransection Dof Dthe Dvena Dcava, Dthe Dbest
Doption Dis Dliga Dtion. DRepair Dof Dthe Dvena Dcava Dis Dusually Dthe Dpreferred Doption; Dhowever, Dthis Dmay
Dnot Dbe Dfeasible Din Dthe Ds Detting D of D damage D control D laparotomy D in D an D unstable D patient D with
D multiple D injuries D where D prolonging D th De Doperative Dtime Drisks Ddeveloping Dcoagulopathy, Dacidosis,
Dand Dhypothermia Dprior Dto Dcontrol Dof Dall Dmajor Dbleeding D sources. D A D left D medial D visceral D rotation
D is D performed D for D aortic D exposure D from D the D hiatus D to D th De Diliacs. DA Dright Dmedial Dvisceral
Drotation Dis Drequired Dfor Dcaval Dexposure.
A D 55-year-
old Dman Dpresents Dwith Dhemodynamic Dinstability Dand Dsevere Dabdominal Dpain Dafter Dbeing Dstruck Dby
Da Dcar. DOn Dexploratory Dlaparotomy, Dhe Dis Dfound Dto Dhave Da Dgrade D5 Dsplenic Dinjury Dand Da D6-cm
Dleft-
sided Dzone DII Dretroperitoneal Dhematoma Dthat Dis Dnot Dexpanding. DMicroscopic Dhematuria Dwas Dalso
Ddetecte D d Don Durinalysis. DAfter Dperforming Dsplenectomy, Dwhat Dis Dthe Dnext Dstep Din Dmanagement?
A. Explore D the D zone D II D retroperitoneal D hematoma.
B. Observe D the D zone D II D hematoma.
C. Perform Da D left D nephrectomy.
D. Perform Dan Don-table Dangiogram. D- DCORRECT DANSWER D-Observe Dthe Dzone DII
D hematoma. DCorrect.
CORRECT ANSWERS 2025
A 34-year-old female presents after a high-
velocity MVC with right flank pain and frank bright red blood in her urine. Her primary survey is intact
, and vital signs are HR 112 bpm, BP 86/59 mmHg, RR 20/min, and oxygen saturation is 98% on room
air. CT scan demonstrates a Grade IV laceration to the right kidney. The best choice for management is
:
A. Renorrhaphy
B. Packing of the renal fossa, temporary abdominal closure, and return to the ICU.
C. Total nephrectomy
D. Observation in the intensive care unit with blood transfusion as needed
E. Gelfoam angioembolization - CORRECT ANSWER -Renorrhaphy
Correct.
This patient is hemodynamically unstable, and therefore should be taken to the operating room for lap
arotomy and renal exploration. Principles of operative repair for a Grade IV, and for some Grade V kid
ney lacerations include renal preservation, when possible—debridement of non-
viable tissue, hemostasis using absorbable sutures in a figure-of-
eight fashion with care taken to preserve arterial supply to distal segments, closure of the collecting sy
stem with absorbable suture in a running fashion, and reapproximation of the capsule. An omental fla
p can be substituted for large defects if necessary. Damage control laparotomy is not indicated in this
patient in the absence of coagulopathy, hypothermia, or acidosis.
A 19-year-
old male presents to the emergency room after a motorcycle crash. Digital rectal exam including the p
rostate is normal, and there is no blood at the urethral meatus. He has a lateral compression pelvis fra
cture and gross hematuria. The appropriate evaluation for this patient would include:
A. Retrograde cystogram
B. Retrograde cystogram and contrast CT scan of the abdomen and pelvis
C. Contrast CT scan of the abdomen and pelvis
D. Retrograde urethrogram - CORRECT ANSWER -
Retrograde cystogram and contrast CT scan of the abdomen and pelvis
Correct.
The combination of a cystogram and a contrast CT scan of the abdomen and pelvis will diagnose pote
ntial bladder and renal injuries. No retrograde urethrogram (D) is needed as the patient did not have a
, high-
riding Dprostate Don Ddigital Drectal Dexam Dand Ddid Dnot Dhave Dblood Dat Dthe Durethral Dmeatus. DA
Dcystogram Dalon D e D (A) D would D not D evaluate D for D renal D injuries D which D are D possible D with D the
D given D mechanism D and D hematuri
a. D A D CT D scan D alone D (C) D would D not D evaluate D for D a D potential D bladder D injury D which D is D possible
D with D the D give Dn Dmechanism Dand Dhematuria.
A D 30-year-
old Dman Dpresents Dto Dthe DEmergency DDepartment Dafter Dbeing Dstruck Dby Da Dmotor Dvehicle; Dhe Dwas
Dfound Dp Dinned Dunder Dthe Dvehicle Dand Drequired D30 Dminutes Dof Dextrication. DOn Darrival, Dhis Dblood
Dpressure Dis D76/50 DmmHg, Dpulse D132 Dbeats/min, Dand Dhe Dis Dslow Dto Drespond Dto Dstimuli. DA Dmassive
Dtransfusion Dprotocol Dis Din Ditiated. DThe DFAST Dscan Dis Dpositive. DOn Dexploration, Dhe Dhas Da Dlarge Dzone
DI Dretroperitoneal Dhematoma, Da Dla Drge Dvolume Dof Dfree Dintraperitoneal Dblood, Dseveral Dsmall Dbowel
Dlacerations, Dand Da Dgrade DIII Dliver Dlaceratio
n. DAfter Dpacking Dthe Dfour Dquadrants, Dexploration Dof Dthe Dhematoma Ddemonstrates Dcomplete
Dtransection D of Dthe Dvena Dcava Dbelow Dthe Drenal Dveins. DThe Dpatient Dremains Dhemodynamically
Dunstable Ddespite Dtransfu Dsion. DWhat Dis Dyour Dnext Dstep Din Dmanagement Dof Dthe Dvena Dcaval Dinjury?
A. Perform Da Dright D medial Dvisceral Drotation, D apply D clamps D proximally D and Ddistally D on Dthe D cava,
D and Drepai D r Dthe Dinjury Dprimarily.
B. Insert Da D- DCORRECT DANSWER D-Perform Da Dright Dmedial Dvisceral Drotation Dand Dligate Dthe
D vena Dcava. DCorrect.
In Dthe Dsetting Dof Dan Dunstable Dpatient Dwith Dcomplete Dtransection Dof Dthe Dvena Dcava, Dthe Dbest
Doption Dis Dliga Dtion. DRepair Dof Dthe Dvena Dcava Dis Dusually Dthe Dpreferred Doption; Dhowever, Dthis Dmay
Dnot Dbe Dfeasible Din Dthe Ds Detting D of D damage D control D laparotomy D in D an D unstable D patient D with
D multiple D injuries D where D prolonging D th De Doperative Dtime Drisks Ddeveloping Dcoagulopathy, Dacidosis,
Dand Dhypothermia Dprior Dto Dcontrol Dof Dall Dmajor Dbleeding D sources. D A D left D medial D visceral D rotation
D is D performed D for D aortic D exposure D from D the D hiatus D to D th De Diliacs. DA Dright Dmedial Dvisceral
Drotation Dis Drequired Dfor Dcaval Dexposure.
A D 55-year-
old Dman Dpresents Dwith Dhemodynamic Dinstability Dand Dsevere Dabdominal Dpain Dafter Dbeing Dstruck Dby
Da Dcar. DOn Dexploratory Dlaparotomy, Dhe Dis Dfound Dto Dhave Da Dgrade D5 Dsplenic Dinjury Dand Da D6-cm
Dleft-
sided Dzone DII Dretroperitoneal Dhematoma Dthat Dis Dnot Dexpanding. DMicroscopic Dhematuria Dwas Dalso
Ddetecte D d Don Durinalysis. DAfter Dperforming Dsplenectomy, Dwhat Dis Dthe Dnext Dstep Din Dmanagement?
A. Explore D the D zone D II D retroperitoneal D hematoma.
B. Observe D the D zone D II D hematoma.
C. Perform Da D left D nephrectomy.
D. Perform Dan Don-table Dangiogram. D- DCORRECT DANSWER D-Observe Dthe Dzone DII
D hematoma. DCorrect.
