UPDATE/PRACTICE QUESTIONS AND
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A 22 year old male is brought by ambulance to a small community hospital
after falling from the top of an 8 foot ladder. Initially, he was found to have a
large right pneumothorax. A chest tube was inserted and connected to an
underwater seal drainage collection system with negative pressure. A
repeat CXR demonstrates a residual, large right pneumothorax. After
transferring the patient to a verified trauma center, a third chest x-ray
reveals a persistent right pneumothorax. The chest tube appears to be
functioning and in good position. He remains hemodynamically normal with
,no signs of respiratory distress. The most likely cause for the persistent
right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury - 🧠 ANSWER ✔✔E. Tracheobronchial injury
Which of the following is LEAST reliable for diagnosing ESOPHAGEAL
intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray - 🧠 ANSWER ✔✔D. oxygen saturation
>92%
-> if it says ESOPHAGEAL, go with this answer
,Which of the following signs necessitates the need for a definitive airway in
severe trauma patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12 - 🧠 ANSWER ✔✔C. Severe maxillofacial trauma
Twenty seven people are severely injured in an aircraft crash at a local
airport. The principles of triage include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available resources -
🧠 ANSWER ✔✔E. Produce the greatest number of survivors based on
available resources
Which of the following statements are correct?
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3
, A. Cerebral contusions may coalesce to form an intracerebral hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal
artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas - 🧠
ANSWER ✔✔A. Cerebral contusions may coalesce to form an intracerebral
hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
An 18 year old male is brought to the ED after being shot. He has one
bullet wound just below the right clavicle and another just below the costal
margin in the right posterior axillary line. His blood pressure is 110/60,
heart rate of 90, and respiratory rate of 34. After ensuring a patent airway
and inserting 2 large caliber IV lines, the next most appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid