ATLS EXAM Questions and Verified Answers () 100%
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True or false? Although the mechanism of injury may be similar to those for the younger
population, data shows increased mortality with similar severity of injury in older adults. -
correct answer True
In the elderly population, what is decreased physiological reserve? - correct answer aging is
characterized by impaired adaptive and homeostatic mechanisms that caused an increased
susceptibility to the stress of injury. Insults tolerated by the younger population can lead to
devastating results in elderly patients.
Pre-existing conditions that affect morbidity and mortality include: - correct answer cirrhosis,
coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - correct answer Fall. Nonfatal
falls are common in women and fractures are common in women who fall. Falls are the most
common cause of TBI.
In the elderly population, what are risk factors for falls? - correct answer advanced age, physical
impairment, history of previous fall, medication use, dementia, unsteady gait, and visual,
cognitive impairment
Most of elderly traffic fatalities occur in the daytime and on weekends and typically involve
other vehicles. Why? - correct answer Older people drive on more familiar roads and at lower
speeds and tend to drive during the day. Older people have slower reaction time, a larger blind
spot, limited cervical mobility, decreased hearing, and cognitive impairment.
True or False? Mortality associated with small to moderate sized burns in older adults remains
high - correct answer True
Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an adequate
number of hair follicles, will result in a full thickness burn in older patients. - correct answer this
is true
Airway-patients may have dentures that may loosen or obstruct the airway. If dentures are not
obstructing the airway, leave them in place for what? - correct answer bag mask ventilation, as
it improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos, barbiturates, and other
sedatives should be reduced to what percentage to minimize the risk of cardiovascular
depression? - correct answer 20-40%
,Functional changes in cardiac system include declining function, decreased sensitivity to
catecholamines, atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta
blockers) - correct answer this results in lack of classic response to hypovolemia, risk for cardiac
ischemia, elevated BP at baseline, and increased risk of dysrythmias.
Functional changes in pulmonary system include decreased elastic recoil, reduced residual
capacity, decreased gas exchange and decreased cough reflex - correct answer thus they are at
increased risk for respiratory failure, increased risk for pneumonia, and poor tolerance to rib
fractures
Functional changes in renal system include loss of renal mass, decreased GFR, and decreased
sensitivity to ADH and aldosterone - correct answer resulting in drug dosing for renal
insufficiency, decreased ability to concentrate urine, increased risk for AKI and urine flow may
be normal with hypovolemia
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints and
cartilage, c spine degenerative changes and loss of skin elastin and subcutaneous fat - correct
answer resulting in increased risk for fractures, decreased mobility, difficulty for oral
intubation, risk of skin injury, increased risk for hypothermia, challenges in rehabiliation
Functional changes in Endocrine system include decreased production and response to thyroxin
and decreased dehydroepiandrosterone (DHEA) - correct answer resulting in occult
hypothyroidism, relative hypercortisone states and increased risk of infection
True or false: Arthritis can complicate the airway and cervical spine. Patients can have
multilevel degenerative changes affecting disk spaces and posterior elements associated with
severe central canal stenosis, cord compression, and myelomalacia - correct answer true
In elderly population, due to their changes in pulmonary system, placing a gauze between gums
and cheek to achieve seal when using bag valve mask ventilation is okay. In addition, because
aging causes a suppressed heart rate response to hypoxia...... - correct answer respiratory
failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at significant
risk for being inaccurately categorized as hemodynamically stable. - correct answer Elderly
patients have a fixed heart rate and fixed cardiac output, thus, their response to hypovolemia
will involve increasing their systemic vascular resistance. Furthermore, since older patients
have HTN, an acceptable BP may truly reflect a hypotensive state. A systolic BP of 110 is to be
utilized as the threshold for identifying hypotension in patients 65 and older.
Do no equate blood pressure with shock in older patients - correct answer BP in older patients
may look normal due to the medications they are on. Use lactate and base deficit to evaluate
for evidence of shock
, what 2 factors place elderly patients at risk for intracranial hemorrhage? - correct answer aging
causes dura to become more adherent to the skull increasing risk of injury and older patients
are on anticoagulant and antiplatelet medications.
Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions place elderly
patients as risk for hypothermia and complications for immobility. - correct answer Rapid
evaluation and when possible early liberation from spine boards and cervical collars will
minimize complications.
True or False: Fall prevention is the mainstay of reducing the mortality associated with pelvic
fractures. - correct answer true
poor hygiene, dehydration, oral injury, contusions affecting the inner arms, inner thighs, palms,
soles, scalp, ear, nasal bridge and temple injury from being struck while wearing glasses,
contact burns and scalds. These are all signs of.......? - correct answer Elder maltreatment. The
presence of physical findings of maltreatment should prompt a detailed history. if history
conflicts with findings, immediately report findings to authorities.
True of false: early activation of the trauma team may be required for elderly patients who do
not meet traditional criteria for activation - correct answer True. A simple injury such as an
open tibia fracture in a frail elderly patient may become life threatening.
Common mechanisms of injury include falls, MVC, burns, and penetrating injuries - correct
answer common injuries in the elderly include rib fractures, TBI, pelvic fractures
The best initial treatment for the fetus is to provide optimal resuscitation of the mother. True
or False? - correct answer True. Also if xray examination is indicated during the pregnant
patient's treatment, it should not be withheld because of the pregnancy.
What happens as the uterus enlarged and the bowel is pushed cephalad. - correct answer
When the uterus enlarges it pushes the bowel cephalad and the uterus lies in the upper
abdomen. As a result, the bowel is somewhat protected from blunt abdominal trauma, whereas
the uterus and its contents (fetus and placenta) become more vulnerable. Uterus remains
intrapelvic until 12 weeks and then at 20 weeks it is at the umbilicus, and at 34-36 weeks it
reaches the costal margin.
Amniotic fluid can cause amniotic fluid embolism and disseminated intravascular coagulation
following trauma if fluid enters maternal intravascular space. True or False - correct answer
True
By the third trimester, what is the complication of trauma to the pelvis of the mother? - correct
answer by the third trimester, the uterus is large and thin walled. In vertex presentation, fetal
head is usually in the pelvis and the remainder of the fetus is exposed above the pelvic brim.
Pelvic fractures in late gestation can result in skull fracture or intracranial injury to the fetus.
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True or false? Although the mechanism of injury may be similar to those for the younger
population, data shows increased mortality with similar severity of injury in older adults. -
correct answer True
In the elderly population, what is decreased physiological reserve? - correct answer aging is
characterized by impaired adaptive and homeostatic mechanisms that caused an increased
susceptibility to the stress of injury. Insults tolerated by the younger population can lead to
devastating results in elderly patients.
Pre-existing conditions that affect morbidity and mortality include: - correct answer cirrhosis,
coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - correct answer Fall. Nonfatal
falls are common in women and fractures are common in women who fall. Falls are the most
common cause of TBI.
In the elderly population, what are risk factors for falls? - correct answer advanced age, physical
impairment, history of previous fall, medication use, dementia, unsteady gait, and visual,
cognitive impairment
Most of elderly traffic fatalities occur in the daytime and on weekends and typically involve
other vehicles. Why? - correct answer Older people drive on more familiar roads and at lower
speeds and tend to drive during the day. Older people have slower reaction time, a larger blind
spot, limited cervical mobility, decreased hearing, and cognitive impairment.
True or False? Mortality associated with small to moderate sized burns in older adults remains
high - correct answer True
Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an adequate
number of hair follicles, will result in a full thickness burn in older patients. - correct answer this
is true
Airway-patients may have dentures that may loosen or obstruct the airway. If dentures are not
obstructing the airway, leave them in place for what? - correct answer bag mask ventilation, as
it improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos, barbiturates, and other
sedatives should be reduced to what percentage to minimize the risk of cardiovascular
depression? - correct answer 20-40%
,Functional changes in cardiac system include declining function, decreased sensitivity to
catecholamines, atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta
blockers) - correct answer this results in lack of classic response to hypovolemia, risk for cardiac
ischemia, elevated BP at baseline, and increased risk of dysrythmias.
Functional changes in pulmonary system include decreased elastic recoil, reduced residual
capacity, decreased gas exchange and decreased cough reflex - correct answer thus they are at
increased risk for respiratory failure, increased risk for pneumonia, and poor tolerance to rib
fractures
Functional changes in renal system include loss of renal mass, decreased GFR, and decreased
sensitivity to ADH and aldosterone - correct answer resulting in drug dosing for renal
insufficiency, decreased ability to concentrate urine, increased risk for AKI and urine flow may
be normal with hypovolemia
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints and
cartilage, c spine degenerative changes and loss of skin elastin and subcutaneous fat - correct
answer resulting in increased risk for fractures, decreased mobility, difficulty for oral
intubation, risk of skin injury, increased risk for hypothermia, challenges in rehabiliation
Functional changes in Endocrine system include decreased production and response to thyroxin
and decreased dehydroepiandrosterone (DHEA) - correct answer resulting in occult
hypothyroidism, relative hypercortisone states and increased risk of infection
True or false: Arthritis can complicate the airway and cervical spine. Patients can have
multilevel degenerative changes affecting disk spaces and posterior elements associated with
severe central canal stenosis, cord compression, and myelomalacia - correct answer true
In elderly population, due to their changes in pulmonary system, placing a gauze between gums
and cheek to achieve seal when using bag valve mask ventilation is okay. In addition, because
aging causes a suppressed heart rate response to hypoxia...... - correct answer respiratory
failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at significant
risk for being inaccurately categorized as hemodynamically stable. - correct answer Elderly
patients have a fixed heart rate and fixed cardiac output, thus, their response to hypovolemia
will involve increasing their systemic vascular resistance. Furthermore, since older patients
have HTN, an acceptable BP may truly reflect a hypotensive state. A systolic BP of 110 is to be
utilized as the threshold for identifying hypotension in patients 65 and older.
Do no equate blood pressure with shock in older patients - correct answer BP in older patients
may look normal due to the medications they are on. Use lactate and base deficit to evaluate
for evidence of shock
, what 2 factors place elderly patients at risk for intracranial hemorrhage? - correct answer aging
causes dura to become more adherent to the skull increasing risk of injury and older patients
are on anticoagulant and antiplatelet medications.
Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions place elderly
patients as risk for hypothermia and complications for immobility. - correct answer Rapid
evaluation and when possible early liberation from spine boards and cervical collars will
minimize complications.
True or False: Fall prevention is the mainstay of reducing the mortality associated with pelvic
fractures. - correct answer true
poor hygiene, dehydration, oral injury, contusions affecting the inner arms, inner thighs, palms,
soles, scalp, ear, nasal bridge and temple injury from being struck while wearing glasses,
contact burns and scalds. These are all signs of.......? - correct answer Elder maltreatment. The
presence of physical findings of maltreatment should prompt a detailed history. if history
conflicts with findings, immediately report findings to authorities.
True of false: early activation of the trauma team may be required for elderly patients who do
not meet traditional criteria for activation - correct answer True. A simple injury such as an
open tibia fracture in a frail elderly patient may become life threatening.
Common mechanisms of injury include falls, MVC, burns, and penetrating injuries - correct
answer common injuries in the elderly include rib fractures, TBI, pelvic fractures
The best initial treatment for the fetus is to provide optimal resuscitation of the mother. True
or False? - correct answer True. Also if xray examination is indicated during the pregnant
patient's treatment, it should not be withheld because of the pregnancy.
What happens as the uterus enlarged and the bowel is pushed cephalad. - correct answer
When the uterus enlarges it pushes the bowel cephalad and the uterus lies in the upper
abdomen. As a result, the bowel is somewhat protected from blunt abdominal trauma, whereas
the uterus and its contents (fetus and placenta) become more vulnerable. Uterus remains
intrapelvic until 12 weeks and then at 20 weeks it is at the umbilicus, and at 34-36 weeks it
reaches the costal margin.
Amniotic fluid can cause amniotic fluid embolism and disseminated intravascular coagulation
following trauma if fluid enters maternal intravascular space. True or False - correct answer
True
By the third trimester, what is the complication of trauma to the pelvis of the mother? - correct
answer by the third trimester, the uterus is large and thin walled. In vertex presentation, fetal
head is usually in the pelvis and the remainder of the fetus is exposed above the pelvic brim.
Pelvic fractures in late gestation can result in skull fracture or intracranial injury to the fetus.
