En un mercado de Oaxaca, entre puestos de especias y
huipiles bordados, había una señora que cosía el tiempo.
Nadie se lo decía directamente a los turistas. Pero los
locales lo sabían: si llevabas a doña Petra un momento
que querías guardar — una tarde de infancia, el último
abrazo de alguien querido, una hora perfecta — ella lo
ATLS POST
cosía en una tela y te lo devolvía doblado.
Cuando lo abrías en casa y lo extendías sobre tus
rodillas, el momento regresaba. Completo. Con olores,
temperatura, palabras exactas.
Un hombre llamado Rodrigo llegó con algo inusual. No
TEST 2026
quería guardar un recuerdo bonito. Quería que ella
cosiera el momento en que su padre le dijo que estaba
orgulloso de él — palabras que nunca habían sido dichas.
Doña Petra lo miró largo rato.
QUESTIONS
«Eso no pasó», dijo finalmente.
«Lo sé», respondió Rodrigo.
Ella asintió despacio. Trabajó tres días. Cuando Rodrigo
abrió la tela, escuchó la voz de su padre — no como
habría sonado, sino como debería haber sonado. Cálida.
&
Segura. Real de una manera diferente.
Salió del mercado llorando y sintiéndose, por primera vez
en décadas, completo.
ANSWERS
, 6
1. The primary indication for transferring a 4. Which one of the following statements
patient to a higher level trauma center is: regarding patients with thoracic spine injuries is
TRUE?
unavailability of a surgeon or operating room Log-rolling may be destabilizing to
staff. fractures from T-12 to L-1.
multiple system injuries, including severe Adequate immobilization can be
head injury. accomplished with the scoop stretcher.
resource limitations as determined by the Spinal cord injury below T-10 usually spares
transferring doctor. bowel and bladder function.
resource limitations as determined by the Hyperflexion fractures in the upper
hospital administration. thoracic spine are inherently unstable.
widened mediastinum on chest x-ray These patients rarely present with spinal
following blunt thoracic trauma. shock in association with cord injury.
2. teen-aged bicycle rider is hit by
b y a truck 5. young man sustains a ritle wound to the mid-
traveling at a high rate of speed. In the abdomen. He is brought promptly to the
emergency department, she is actively bleeding emergency department by prehospital
from open fractures of her legs, and has personnel. His skin is cool and diaphoretic, and
abrasions on her chest and abdominal wall. Her his systolic blood pressure is 58 rnm Hg.
blood pressure is 80/50 mm Hg, heart rate is Warmed crystalloid fluids are initiated without
140 beats per minute, respiratory rate is 8 improvement in his vital signs. The next, most
breaths per minute, and GCS score is 6. appropriate step is to perform:
The first step in managing this patient is to: a celiotomy.
an abdominal CT scan.
obtain a lateral cervical spine x-ray. diagnostic laparoscopy.
insert a central venous pressure line. abdominal ultrasonography.
administer 2 liters of crystalloid solution. a diagnostic peritoneal lavage.
perform endotracheal intubation and
ventilation.
apply the PASG and inflate the leg
6. young woman sustains a severe headhe ad injury
compartments. as the result of a motor vehicular crash. In the
emergency department, her GCS score is 6. Her
blood pressure is 140/90 mm Hg and her heart
3. Contraindication to nasogastric intubation is rate is 80 beats per minute. She is intubated and
the presence of a: is being mechanically ventilated. Her pupils are
gastric perforation. 3 mm in size and equally
equall y reactive to light.
diaphragmatic rupture. There is no other apparent injury. The most
open depressed skull fracture. important principle to follow in the early
fracture of the cervical spine. management of her head injury is to:
fracture of the cribriform plate.
administer an osmotic diuretic.
prevent secondary brain injury.
, RRERERETEFWGFFDHDF
aggressively treat systemic hypertension. 9. 8-year-old girl is an unrestrained passenger
reduce metabolic requirements of the in a vehicle struck from behind. In the
brain. emergency department, her blood pressure is
distinguish between intracranial hematoma 80/60 mm Hg, heart rate is 80 beats per minute,
and cerebral edema. and respiratory rate is 16 breaths per minute.
Her GCS score is 14. She complains that her
legs feel "funny and won't move right;"
7. 22-year-old man is brought to the hospital
however, her spine x-rays do not show a
after crashing his motorcycle into a telephone
fracture or dislocation. A spinal cord injury in
pole. He is unconscious and in profound shock.
this child:
He has no open wounds or obvious fractures.
En un
The cause of his shock mercado
is MOST LIKELY de Oaxaca, entre puestos de
is most likely a central cord syndrome.
caused by: especias y huipiles bordados, había una señora que
must be diagnosed by magnetic resonance
imaging.
cosía el tiempo.
a subdural hematoma.
can be excluded by obtaining a CT of the
Nadie se hematoma.
lo decía directamente a los turistas. Peroentire spine.
an epidural
los locales
a transected lo sabían:
lumbar spinal cord. si llevabas may a doña
exist inPetra un of objective
the absence
momento
a transected quecord.
cervical spinal querías guardar — una tarde
de on x-ray studies.
findings
infancia, el último abrazo de alguien
hemorrhage into the chest or abdomen.
querido,
is unlikely because una
of the incomplete
hora perfecta — ella lo cosía en una tela yoftethelovertebral bodies.
calcification
8. 30-year-old man devolvía
is struck by doblado.
a car traveling
at 56 kph (35 mph). Cuando lo abrías
He has obvious en casa
fractures of y lo
10.extendías
Immediate chest sobretube tus
insertion is indicated
the left tibia near rodillas, el momento regresaba.
the knee, pain in the pelvic Completo.
for which Con conditions?
of the following
olores,His
area, and severe dyspnea. temperatura,
heart rate is 180palabras exactas. Pneumothorax
Un hombre llamado Rodrigo llegó con algo inusual.
beats per minute, and his respiratory rate is 48 Pneumomediastinum
breaths per minute with no breath sounds heard
No quería guardar un recuerdo bonito. Quería quehemothorax
Massive
in the left chest. A tension pneumothorax is
ella cosiera el
relieved by immediate needle decompression
momento en que su padre le dijo que
Diaphragmatic rupture
estaba
and tube thoracostomy. orgullosohisde
Subsequently, él — palabras que nunca
heart
Subcutaneous emphysema
habían
rate decreases to 140 sido
beats per dichas.
minute, his
Doña Petra
respiratory rate decreases lo miró
to 36 breaths per largo rato. 11. 18-year-old, helmeted motorcyclist is
«Eso
minute, and his blood no pasó»,
pressure is 80/50 dijo finalmente.
inm Hg. brought by ambulance to the emergency
Warmed Ringer's «Lo lactatesé», respondió Rodrigo.department following a high-speed crash.
is administered
intravenously. TheElla nextasintió despacio.
priority should be to: Trabajó tres días.
Prehospital Cuando
persormel report that he was thrown
Rodrigo abrió la tela, escuchó
perform a urethrogram and cystogram.
la voz de su padre —
15 meters (50 feet) off his bfice. He has a
history of hypotension prior to arrival in the
no como habría sonado, sino como debería haber
perform external fixation of the pelvis.
obtain abdominal and pelvic CT scans. emergency department, but is now awake, alert,
sonado. Cálida. Segura. Real de una manera
perform arterial embolization of the pelvic and conversational. Which of the following
diferente. vessels.
statements is TRUE?
Salió
perform diagnostic del mercado
peritoneal lavage or llorando y sintiéndose,
por perfiision is intacto
Cerebral
primera
abdominalvez en décadas, completo.
ultrasound. Intravascular volume status is normal.
The patient has sensitive vasomotor
reflexes.
2
huipiles bordados, había una señora que cosía el tiempo.
Nadie se lo decía directamente a los turistas. Pero los
locales lo sabían: si llevabas a doña Petra un momento
que querías guardar — una tarde de infancia, el último
abrazo de alguien querido, una hora perfecta — ella lo
ATLS POST
cosía en una tela y te lo devolvía doblado.
Cuando lo abrías en casa y lo extendías sobre tus
rodillas, el momento regresaba. Completo. Con olores,
temperatura, palabras exactas.
Un hombre llamado Rodrigo llegó con algo inusual. No
TEST 2026
quería guardar un recuerdo bonito. Quería que ella
cosiera el momento en que su padre le dijo que estaba
orgulloso de él — palabras que nunca habían sido dichas.
Doña Petra lo miró largo rato.
QUESTIONS
«Eso no pasó», dijo finalmente.
«Lo sé», respondió Rodrigo.
Ella asintió despacio. Trabajó tres días. Cuando Rodrigo
abrió la tela, escuchó la voz de su padre — no como
habría sonado, sino como debería haber sonado. Cálida.
&
Segura. Real de una manera diferente.
Salió del mercado llorando y sintiéndose, por primera vez
en décadas, completo.
ANSWERS
, 6
1. The primary indication for transferring a 4. Which one of the following statements
patient to a higher level trauma center is: regarding patients with thoracic spine injuries is
TRUE?
unavailability of a surgeon or operating room Log-rolling may be destabilizing to
staff. fractures from T-12 to L-1.
multiple system injuries, including severe Adequate immobilization can be
head injury. accomplished with the scoop stretcher.
resource limitations as determined by the Spinal cord injury below T-10 usually spares
transferring doctor. bowel and bladder function.
resource limitations as determined by the Hyperflexion fractures in the upper
hospital administration. thoracic spine are inherently unstable.
widened mediastinum on chest x-ray These patients rarely present with spinal
following blunt thoracic trauma. shock in association with cord injury.
2. teen-aged bicycle rider is hit by
b y a truck 5. young man sustains a ritle wound to the mid-
traveling at a high rate of speed. In the abdomen. He is brought promptly to the
emergency department, she is actively bleeding emergency department by prehospital
from open fractures of her legs, and has personnel. His skin is cool and diaphoretic, and
abrasions on her chest and abdominal wall. Her his systolic blood pressure is 58 rnm Hg.
blood pressure is 80/50 mm Hg, heart rate is Warmed crystalloid fluids are initiated without
140 beats per minute, respiratory rate is 8 improvement in his vital signs. The next, most
breaths per minute, and GCS score is 6. appropriate step is to perform:
The first step in managing this patient is to: a celiotomy.
an abdominal CT scan.
obtain a lateral cervical spine x-ray. diagnostic laparoscopy.
insert a central venous pressure line. abdominal ultrasonography.
administer 2 liters of crystalloid solution. a diagnostic peritoneal lavage.
perform endotracheal intubation and
ventilation.
apply the PASG and inflate the leg
6. young woman sustains a severe headhe ad injury
compartments. as the result of a motor vehicular crash. In the
emergency department, her GCS score is 6. Her
blood pressure is 140/90 mm Hg and her heart
3. Contraindication to nasogastric intubation is rate is 80 beats per minute. She is intubated and
the presence of a: is being mechanically ventilated. Her pupils are
gastric perforation. 3 mm in size and equally
equall y reactive to light.
diaphragmatic rupture. There is no other apparent injury. The most
open depressed skull fracture. important principle to follow in the early
fracture of the cervical spine. management of her head injury is to:
fracture of the cribriform plate.
administer an osmotic diuretic.
prevent secondary brain injury.
, RRERERETEFWGFFDHDF
aggressively treat systemic hypertension. 9. 8-year-old girl is an unrestrained passenger
reduce metabolic requirements of the in a vehicle struck from behind. In the
brain. emergency department, her blood pressure is
distinguish between intracranial hematoma 80/60 mm Hg, heart rate is 80 beats per minute,
and cerebral edema. and respiratory rate is 16 breaths per minute.
Her GCS score is 14. She complains that her
legs feel "funny and won't move right;"
7. 22-year-old man is brought to the hospital
however, her spine x-rays do not show a
after crashing his motorcycle into a telephone
fracture or dislocation. A spinal cord injury in
pole. He is unconscious and in profound shock.
this child:
He has no open wounds or obvious fractures.
En un
The cause of his shock mercado
is MOST LIKELY de Oaxaca, entre puestos de
is most likely a central cord syndrome.
caused by: especias y huipiles bordados, había una señora que
must be diagnosed by magnetic resonance
imaging.
cosía el tiempo.
a subdural hematoma.
can be excluded by obtaining a CT of the
Nadie se hematoma.
lo decía directamente a los turistas. Peroentire spine.
an epidural
los locales
a transected lo sabían:
lumbar spinal cord. si llevabas may a doña
exist inPetra un of objective
the absence
momento
a transected quecord.
cervical spinal querías guardar — una tarde
de on x-ray studies.
findings
infancia, el último abrazo de alguien
hemorrhage into the chest or abdomen.
querido,
is unlikely because una
of the incomplete
hora perfecta — ella lo cosía en una tela yoftethelovertebral bodies.
calcification
8. 30-year-old man devolvía
is struck by doblado.
a car traveling
at 56 kph (35 mph). Cuando lo abrías
He has obvious en casa
fractures of y lo
10.extendías
Immediate chest sobretube tus
insertion is indicated
the left tibia near rodillas, el momento regresaba.
the knee, pain in the pelvic Completo.
for which Con conditions?
of the following
olores,His
area, and severe dyspnea. temperatura,
heart rate is 180palabras exactas. Pneumothorax
Un hombre llamado Rodrigo llegó con algo inusual.
beats per minute, and his respiratory rate is 48 Pneumomediastinum
breaths per minute with no breath sounds heard
No quería guardar un recuerdo bonito. Quería quehemothorax
Massive
in the left chest. A tension pneumothorax is
ella cosiera el
relieved by immediate needle decompression
momento en que su padre le dijo que
Diaphragmatic rupture
estaba
and tube thoracostomy. orgullosohisde
Subsequently, él — palabras que nunca
heart
Subcutaneous emphysema
habían
rate decreases to 140 sido
beats per dichas.
minute, his
Doña Petra
respiratory rate decreases lo miró
to 36 breaths per largo rato. 11. 18-year-old, helmeted motorcyclist is
«Eso
minute, and his blood no pasó»,
pressure is 80/50 dijo finalmente.
inm Hg. brought by ambulance to the emergency
Warmed Ringer's «Lo lactatesé», respondió Rodrigo.department following a high-speed crash.
is administered
intravenously. TheElla nextasintió despacio.
priority should be to: Trabajó tres días.
Prehospital Cuando
persormel report that he was thrown
Rodrigo abrió la tela, escuchó
perform a urethrogram and cystogram.
la voz de su padre —
15 meters (50 feet) off his bfice. He has a
history of hypotension prior to arrival in the
no como habría sonado, sino como debería haber
perform external fixation of the pelvis.
obtain abdominal and pelvic CT scans. emergency department, but is now awake, alert,
sonado. Cálida. Segura. Real de una manera
perform arterial embolization of the pelvic and conversational. Which of the following
diferente. vessels.
statements is TRUE?
Salió
perform diagnostic del mercado
peritoneal lavage or llorando y sintiéndose,
por perfiision is intacto
Cerebral
primera
abdominalvez en décadas, completo.
ultrasound. Intravascular volume status is normal.
The patient has sensitive vasomotor
reflexes.
2
