PHTLS 10TH EDITION SELF TEST EXAM 2026
FULL PREPARATION WITH CORRECT ANSWERS
◉ Managing Volume Resuscitation
Controlled Hemorrhage
large scalp or extremity controlled with a tourniquet, PT falls into
class II,III,IV shock Answer: rapid bolus of 1-2 litres
◉ Three responses of initial fluid bolus
Rapid Response Answer: vital signs return indicating that PT lost
less than 20%
PT is best managed at SBP between 80-90, IV fluid should be titrated
◉ Three responses of initial fluid bolus
Transient Response Answer: Vital signs improve (pulse slows, BP
increases) however PT shows deterioration. PT has typically lost 20-
40% of blood volume
◉ Three responses of initial fluid bolus
Minimal or no response Answer: No change in PT after 1-2 liter
Bolus
,◉ Leading cause of TBI Answer: MVC
◉ Three seperate membranes that surround the brain Answer:
meninges
◉ Outer most meninges Answer: Dura mater- composed of tough
fibrous tissue
◉ The inner most meninges that is directly in contact with the brain
Answer: Pia Mater-
◉ Vessels that lay on top of the Pia Mater Answer: Cerebral Blood
Vessels
◉ The meninge that lays in the middle between the dura and pia
matter Answer: Arachnoid membrane-loosely covers the brain and
its blood vessels
◉ MAP-Mean Arterial Pressure Answer: The average pressure for
the entire cardiac cycle
MAP=Diastolic Pressure + 1/3 of the Pulse Pressure
◉ PP- Pulse Pressure Answer: The difference between the systolic
and diastolic
,PP= Systolic (SBP) - Distolic (DBP)
◉ CPP- Cerebral Perfusion Pressure Answer: The amount of
pressure it takes to push blood through the cerebral circulation.
CPP=Mean Arterial pressure (MAP) - Intercranial pressure (ICP)
◉ CPP- is normally below ? mmHg Answer: CPP is normally 15
mmHg or below
◉ Autoregulation Answer: The brain changes the cerebral blood
vessel resistance (CVR) to compensate for changes in the cerebral
pulse pressure (CPP)
◉ For neurological injured PT's the systolic blood pressure is best if
maintained at or above Answer: 90 mmHg
◉ Hyperventilation and TBI Answer: Hyperventilation can reduced
CBF by causing vasoconstriction due to hypocapnia, PaCO2 >35
increases risk of cerebral ischemia
◉ Primary Brain injury Answer: The direct trauma or mechanical
injury, includes contusions, hemorrhages and lacerations
, ◉ Secondary brain injury Answer: pathologic mechanisms that
related to intercranial mass effect, elevated ICP, and herniation,
hemotoma, hypoxia and hypotension
◉ Mass effect Answer: The effect of a growing mass or tumor
◉ Uncal Herniation Answer: temporal lobe epidural hematoma
forces pressure on the medial portion of the temporal lobe (uncus)
which in turn puts pressure on the 3rd cranial nerve causing dilation
or blown pupil on the side of the herniation. May also cause loss of
function of the motor track on the same side.
◉ Final stage of uncal herniation Answer: The RAS is affected
patient lapses into coma
◉ decorticate posturing Answer: flexion of the upper extremities
with rigidity and extension of the lower extremities.
◉ decerebrate posturing Answer: all extrem become flaccid and
motor activity is absent
◉ Cheyne strokes ventilation Answer: repeating cycle of slow hallow
breaths that become deeper and more rapid and then return to slow
FULL PREPARATION WITH CORRECT ANSWERS
◉ Managing Volume Resuscitation
Controlled Hemorrhage
large scalp or extremity controlled with a tourniquet, PT falls into
class II,III,IV shock Answer: rapid bolus of 1-2 litres
◉ Three responses of initial fluid bolus
Rapid Response Answer: vital signs return indicating that PT lost
less than 20%
PT is best managed at SBP between 80-90, IV fluid should be titrated
◉ Three responses of initial fluid bolus
Transient Response Answer: Vital signs improve (pulse slows, BP
increases) however PT shows deterioration. PT has typically lost 20-
40% of blood volume
◉ Three responses of initial fluid bolus
Minimal or no response Answer: No change in PT after 1-2 liter
Bolus
,◉ Leading cause of TBI Answer: MVC
◉ Three seperate membranes that surround the brain Answer:
meninges
◉ Outer most meninges Answer: Dura mater- composed of tough
fibrous tissue
◉ The inner most meninges that is directly in contact with the brain
Answer: Pia Mater-
◉ Vessels that lay on top of the Pia Mater Answer: Cerebral Blood
Vessels
◉ The meninge that lays in the middle between the dura and pia
matter Answer: Arachnoid membrane-loosely covers the brain and
its blood vessels
◉ MAP-Mean Arterial Pressure Answer: The average pressure for
the entire cardiac cycle
MAP=Diastolic Pressure + 1/3 of the Pulse Pressure
◉ PP- Pulse Pressure Answer: The difference between the systolic
and diastolic
,PP= Systolic (SBP) - Distolic (DBP)
◉ CPP- Cerebral Perfusion Pressure Answer: The amount of
pressure it takes to push blood through the cerebral circulation.
CPP=Mean Arterial pressure (MAP) - Intercranial pressure (ICP)
◉ CPP- is normally below ? mmHg Answer: CPP is normally 15
mmHg or below
◉ Autoregulation Answer: The brain changes the cerebral blood
vessel resistance (CVR) to compensate for changes in the cerebral
pulse pressure (CPP)
◉ For neurological injured PT's the systolic blood pressure is best if
maintained at or above Answer: 90 mmHg
◉ Hyperventilation and TBI Answer: Hyperventilation can reduced
CBF by causing vasoconstriction due to hypocapnia, PaCO2 >35
increases risk of cerebral ischemia
◉ Primary Brain injury Answer: The direct trauma or mechanical
injury, includes contusions, hemorrhages and lacerations
, ◉ Secondary brain injury Answer: pathologic mechanisms that
related to intercranial mass effect, elevated ICP, and herniation,
hemotoma, hypoxia and hypotension
◉ Mass effect Answer: The effect of a growing mass or tumor
◉ Uncal Herniation Answer: temporal lobe epidural hematoma
forces pressure on the medial portion of the temporal lobe (uncus)
which in turn puts pressure on the 3rd cranial nerve causing dilation
or blown pupil on the side of the herniation. May also cause loss of
function of the motor track on the same side.
◉ Final stage of uncal herniation Answer: The RAS is affected
patient lapses into coma
◉ decorticate posturing Answer: flexion of the upper extremities
with rigidity and extension of the lower extremities.
◉ decerebrate posturing Answer: all extrem become flaccid and
motor activity is absent
◉ Cheyne strokes ventilation Answer: repeating cycle of slow hallow
breaths that become deeper and more rapid and then return to slow
