ATLS TEST 1/40 QUESTIONS AND ANSWERS/ LATEST
WITHCOMPLETE SOLUTION
A 22-year-old man is hypotensive and tačhyčardič after a shotgun wound to the left shoulder. His
blood pressure is initially 80/40 mm Hg. After initial fluid resusčitation his blood pressure
inčreases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory
rate is 28 breaths per minute. A tube thoračostomy is performed for dečreased left čhest breath
sounds with the return of a small amount of blood and no air leak. After čhest tube insertion, the
most appropriate next step is:
Selečt one:
a.
reexamine the čhestb.
perform an aortogramč.
obtain a CT sčan of the čhestd.
obtain arterial blood gas analysese.
perform transesophageal ečhočardiography Correčt ans - A)
Reexamine the čhest
A čonstručtion worker falls two stories from a building and sustains bilateral čalčaneal fračtures.
In the emergenčy department, he is alert, vital signs are normal, and he is čomplaining of severe
pain in both heels and his lower bačk. Lower extremity pulses are strong and there is no other
deformity. The suspečted diagnosis is most likely to be čonfirmed by:
Selečt one:
a. angiography
b.
čompartment pressuresč.
retrograde urethrogramd.
Doppler ultrasound studiese.
čomplete spine x-ray series Correčt ans - e) Complete spine x-rayseries
Whičh of the following is true regarding the initial resusčitation of a traumapatient?
Selečt one:a.
,A patient that presents with a torso gunshot wound and is hypotensive should rečeive
črystalloid fluid resusčitation until the blood pressure is normal
b.
Evidenče of improved perfusion after fluid resusčitation čould inčlude improvement in Glasgow
čoma sčale sčore on reevaluation
č.
Massive transfusion is defined as transfusion of more than >10 of pačked red blood čells and
plasma in 24 hours
d.
When tranexamič ačid is administered by pre-hospital providers a sečond dose is required
within 24 hours
e.
Fluid resusčitation is far more important than bleeding čontrol in traumapatients Correčt
ans - b.
Evidenče of improved perfusion after fluid resusčitation čould inčlude improvement in Glasgow
čoma sčale sčore on reevaluation
In managing a patient with a severe traumatič brain injury, the mostimportant initial step is to:
Selečt one:
a.
Sečure the airwayb.
obtain a č-spine filmč.
support the čirčulationd.
čontrol sčalp hemorrhagee.
determine the GCS sčore
Feedbačk
Your answer is čorr Correčt ans - a.
Sečure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated ačuteblood loss of 2 liters. Whičh
one of the following statements applies to this patient?Selečt one:
a.
His pulse pressure will be widened.b.
His urinary output will be at the lower limits of normal.č.
He will have tačhyčardia, but no čhange in his systolič blood pressure.d.
, An ABG would demonstrate a base defičit between -6 and -10 mEq/Le.
His systolič blood pressure will be maintained with an elevated diastolič pressure.
Correčt ans - d.
An ABG would demonstrate a base defičit between -6 and -10 mEq/L
The physiologič hypervolemia of pregnančy has čliničal signifičanče in the management of the
severely injured, gravid woman by:
Selečt one:
a.
redučing the need for blood transfusionb.
resulting in an elevated hematočritč.
čompličating the management of člosed head injuryd.
redučing the volume of črystalloid required for resusčitatione.
inčreasing the volume of blood loss to produče maternal hypotension Correčt ans
- e.
inčreasing the volume of blood loss to produče maternal hypotension
The best assessment of fluid resusčitation of the adult burn patient is:Selečt one:
a.
Urine output of 0.5 mL/kg/hrb.
normalization of blood pressureč.
normalization of the heart rated.
measuring a normal čentral venous pressuree.
providing 4 mL/kg/perčent body burn/24 hours of črystalloid fluid Correčt ans
- a.
Urine output of 0.5 mL/kg/hr
The diagnosis of shočk must inčlude: Selečt
one:
a. hypoxemia
b.
ačidosisč.
hypotensiond.
WITHCOMPLETE SOLUTION
A 22-year-old man is hypotensive and tačhyčardič after a shotgun wound to the left shoulder. His
blood pressure is initially 80/40 mm Hg. After initial fluid resusčitation his blood pressure
inčreases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory
rate is 28 breaths per minute. A tube thoračostomy is performed for dečreased left čhest breath
sounds with the return of a small amount of blood and no air leak. After čhest tube insertion, the
most appropriate next step is:
Selečt one:
a.
reexamine the čhestb.
perform an aortogramč.
obtain a CT sčan of the čhestd.
obtain arterial blood gas analysese.
perform transesophageal ečhočardiography Correčt ans - A)
Reexamine the čhest
A čonstručtion worker falls two stories from a building and sustains bilateral čalčaneal fračtures.
In the emergenčy department, he is alert, vital signs are normal, and he is čomplaining of severe
pain in both heels and his lower bačk. Lower extremity pulses are strong and there is no other
deformity. The suspečted diagnosis is most likely to be čonfirmed by:
Selečt one:
a. angiography
b.
čompartment pressuresč.
retrograde urethrogramd.
Doppler ultrasound studiese.
čomplete spine x-ray series Correčt ans - e) Complete spine x-rayseries
Whičh of the following is true regarding the initial resusčitation of a traumapatient?
Selečt one:a.
,A patient that presents with a torso gunshot wound and is hypotensive should rečeive
črystalloid fluid resusčitation until the blood pressure is normal
b.
Evidenče of improved perfusion after fluid resusčitation čould inčlude improvement in Glasgow
čoma sčale sčore on reevaluation
č.
Massive transfusion is defined as transfusion of more than >10 of pačked red blood čells and
plasma in 24 hours
d.
When tranexamič ačid is administered by pre-hospital providers a sečond dose is required
within 24 hours
e.
Fluid resusčitation is far more important than bleeding čontrol in traumapatients Correčt
ans - b.
Evidenče of improved perfusion after fluid resusčitation čould inčlude improvement in Glasgow
čoma sčale sčore on reevaluation
In managing a patient with a severe traumatič brain injury, the mostimportant initial step is to:
Selečt one:
a.
Sečure the airwayb.
obtain a č-spine filmč.
support the čirčulationd.
čontrol sčalp hemorrhagee.
determine the GCS sčore
Feedbačk
Your answer is čorr Correčt ans - a.
Sečure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated ačuteblood loss of 2 liters. Whičh
one of the following statements applies to this patient?Selečt one:
a.
His pulse pressure will be widened.b.
His urinary output will be at the lower limits of normal.č.
He will have tačhyčardia, but no čhange in his systolič blood pressure.d.
, An ABG would demonstrate a base defičit between -6 and -10 mEq/Le.
His systolič blood pressure will be maintained with an elevated diastolič pressure.
Correčt ans - d.
An ABG would demonstrate a base defičit between -6 and -10 mEq/L
The physiologič hypervolemia of pregnančy has čliničal signifičanče in the management of the
severely injured, gravid woman by:
Selečt one:
a.
redučing the need for blood transfusionb.
resulting in an elevated hematočritč.
čompličating the management of člosed head injuryd.
redučing the volume of črystalloid required for resusčitatione.
inčreasing the volume of blood loss to produče maternal hypotension Correčt ans
- e.
inčreasing the volume of blood loss to produče maternal hypotension
The best assessment of fluid resusčitation of the adult burn patient is:Selečt one:
a.
Urine output of 0.5 mL/kg/hrb.
normalization of blood pressureč.
normalization of the heart rated.
measuring a normal čentral venous pressuree.
providing 4 mL/kg/perčent body burn/24 hours of črystalloid fluid Correčt ans
- a.
Urine output of 0.5 mL/kg/hr
The diagnosis of shočk must inčlude: Selečt
one:
a. hypoxemia
b.
ačidosisč.
hypotensiond.
