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TCRN EXAM | FROM QUESTION TO PERFECTION| STUDY WITH CONFIDENCE!

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TCRN EXAM | FROM QUESTION TO PERFECTION| STUDY WITH CONFIDENCE!

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November 11, 2025
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2025/2026
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TCRN EXAM | FROM QUESTION TO PERFECTION|
STUDY WITH CONFIDENCE!
Shock - Answer: Lack of oxygen to the cells



Hypovolemic Shock - Answer: Lack of volume

ex: hemorrhage, burns



Distributive Shock - Answer: Maldistribution of blood (pooled in extremities)

Decreased preload

ex: neurogenic shock



Cardiogenic Shock - Answer: Inadequate cardiac output

ex: blunt cardiac trauma



Obstructive Shock - Answer: Inability of blood to enter or exit heart properly

ex: tamponade, tension pneumothorax



Systemic Inflammatory Response Syndrome (SIRS) - Answer: Severe tissue trauma
activates an inflammatory response leading to vasodilation, capillary permeability, and
coagulation



Early (Compensated) Shock - Answer: Normal BP

Weak, thready pulse

Deep and rapid RR

Normal lactic levels

Anxious

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,Late (Decompensated) Shock - Answer: Decreased BP

Tachycardia

Shallow and rapid RR

Increased Lactic

Decreased LOC

Decreased urinary output



BUN to Creatinine Ratio - Answer: Normal - 10:1

Indicated effective renal function



Trauma Triad of Death - Answer: Hypothermia

Acidosis

Coagulopathies



Effects of Acidosis - Answer: Increased ICP

Exacerbates coagulopathies

Depressed myocardial contractility



DIC - Answer: Excessive clotting > all clotting factors used > no more clotting > excessive
bleeding



Effects of coagulopathies - Answer: Decreased platelet count

Decreased fibrinogen

Decreased HnH

Increased PT, PTT

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,Increased Ddimer



Multi-Organ Dysfunction Syndrome (MODS) - Answer: Irreversible Shock resulting from
Triad of Death

Symptoms start within the first week after trauma



Steps to control hemorrhage - Answer: Tourniquet

TXA

REBOA

Permissive Hypotension



Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) - Answer: Occlusion of
the Aorta below the diaphragm to reduce bleeding



Type A - Answer: RBC: Type A, O

Plasma: Type A, AB



Type B - Answer: RBC: Type B, O

Plasma: Type B, AB



Type AB - Answer: RBC: Type A, B, AB, O

Plasma: AB



Type O - Answer: RBC: Type O

Plasma: Type A, B, AB, O



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, Universal Donor of RBC and Plasma - Answer: Universal donor of RBC: O negative

Universal donor of Plasma: AB negative



Cryoprecipitate - Answer: Concentrate of coagulation factors obtained from fresh frozen
plasma

Increases fibrinogen in the bloodstream



Blood Transfusion in Peds - Answer: One unit of blood is 10ml/kg



Complications of MTP - Answer: Hypothermia - warm all fluids and blood

Hypocalcemia - replace calcium

Acidosis - sodium bicarb

TRALI - stop transfusion, supplemental oxygen



Transfusion-Related Acute Lung Injury (TRALI) - Answer: Pulmonary edema due to rapid
blood administration



MTP Protocol - Answer: 1 : 1 : 1

RBC : Plasma : Platelet



Blood Loss Grades - Answer: I - Loss of 15% with normal BP

II - Loss of 15-30% with normal BP

III - Loss: of 31-40% with lowered BP

IV - Loss > 40% with hemodynamic instability



Permissive Hypotension - Answer: Maintaining BP as low as 70/40 so allow for clotting.

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