A patient is involved in a MVA and suffers multiorgan trauma. He is brought to the ER by
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EMS and found to be hypotensive with bradycardia and his abdomen is not distended.
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He is disoriented and confused. He has a GCS of 9; his legs are warm and the pulses
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thready. His CVP is 9 his HR is 42 and his BP is 80/40. What is the most likely cause of his
L L L L L L L L L L L L L L L L L L L L L L
shock state? L
A. Closed head injury L L
B. Ongoing intra-abdominal hemorrhage L L
C. Pneumothorax
D. Neurogenic shock - ANSWER>>D. Neurogenic shock L L L L L
Which one of the following findings in an adult is most likely to require immediate
L L L L L L L L L L L L L L L
management during the primary survey? L L L L
A. distended abdomen L
B. Glasgow Coma Scale score of 11 L L L L L
C. temperature of 36.5°C (97.8°F) L L L
D. deforming of the right thigh L L L L
E. Respiratory rate of 40 breaths per minute - ANSWER>>E. Respiratory rate of 40
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breaths per minute L L
Which one of the following statements regarding abdominal trauma in the pregnant
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patient is TRUE? L L
A. The fetus is in jeopardy only with major abdominal trauma.
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B. Leakage of amniotic fluid is an indication for hospital admission.
L L L L L L L L L
C. Indications for peritoneal lavage are different from those in the nonpregnant patient.
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,D. With penetrating trauma injury to the mother's abdominal hollow viscus is more
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common in late than in early pregnancy.
L L L L L L
E. The secondary survey follows a different pattern from that of the nonpregnant
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patient. - ANSWER>>B. Leakage of amniotic fluid is an indication for hospital admission.
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The most important immediate step in the management of an open pneumothorax is:
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A. endotracheal intubation L
B. operation to close the wound L L L L
C. placing a chest tube through the chest wound
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D. placement of an occlusive dressing over the wound L L L L L L L
E. initiation of 2 large-caliber IVs with crystalloid solutionE. - ANSWER>>D. placement of an
L L L L L L L L L L L L L
occlusive dressing over the wound
L L L L
The following are contraindications for tetanus toxoid administration:
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A. history of neurological reaction or severe hypersensitivity to the product
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B. local side effects
L L
C. muscular spasms L
D. pregnancy
E. all of the above - ANSWER>>A. history of neurological reaction or severe
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hypersensitivity to the product L L L
A 56-year-old man is thrown violently against the steering wheel of his truck during a
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motor vehicle crash. On arrival in the emergency department he is diaphoretic and
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complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40
L L L L L L L L L L L L L L L L L
breaths per minute. Which of the following best differentiates cardiac tamponade from
L L L L L L L L L L L L
tension pneumothorax as the cause of his hypotension?
L L L L L L L
A. Tachycardia
,B. pulse volume L
C. breath sounds L
D. pulse pressure L
E. jugular venous pressure - ANSWER>>C. breath sounds
L L L L L L
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
L L L L L L L L L L L L L L
endotracheal intubation because: L L
A. The trachea is relatively short.
L L L L
B. The distance from the lips to the larynx is relatively short.
L L L L L L L L L L
C. The use of cuffed endotracehal tubes eliminates this issue.
L L L L L L L L
D. The mainstem bronchi are less angulated in their relation to the trachea.
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E. So little friction exists between the endotracheal tube and the wall of the trachea. -
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ANSWER>>A. The trachea is relatively short. L L L L L
Which one of the following is the most effective method for initially treating frostbite?
L L L L L L L L L L L L L
A. moist heat L
B. early amputation
L
C. padding and elevation L L
D. vasodilators and heparin L L
E. topical application of silver sulfadiazine - ANSWER>>A. moist heat
L L L L L L L L
Which one of the following statements concerning intraosseous infusion is TRUE?A. Only
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crystalloid solutions may be safely infused through the needle.
L L L L L L L L
B. Aspiration of bone marrow confirms appropriate positioning of the needle.
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C. Intraosseous infusion is the preferred route for volume resuscitation in small children.
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, D. Intraosseous infusion may be utilized indefinitely. L L L L L
E. Swelling in the soft tissues around the intraosseous site is not a reason to discontinue
L L L L L L L L L L L L L L L
infusion. - ANSWER>>B. Aspiration of bone marrow confirms appropriate positioning of
L L L L L L L L L L L
the needle.
L
A young woman sustains a severe head injury as the result of a motor vehicle crash. In the
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emergency department her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart
L L L L L L L L L L L L L L L L
rate is 80 beats per minute. She is intubated and mechanically ventilated. Her pupils are 3
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mm in size and equally reactive to light. There is no other apparent injury. The most
L L L L L L L L L L L L L L L L
important principle to follow in the early management of her head injury is to:
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A. avoid hypotension L
B. administer an osmotic diuretic L L L
C. aggressively treat systemic hypertension L L L
D. reduce metabolic requirements of the brain L L L L L
E. distinguish between intracranial hematoma and cerebral edema - ANSWER>>A. avoid
L L L L L L L L L L
hypotension
A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade III
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(moderately severe) splenic injury has been confirmed by computed tomography (CT).
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Which of the following mandates prompt celiotomy (laparotomy)?
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A. a serum amylase of 200
L L L L L
B. a leukocyte count of 14,000
L L L L
C. evidence of retroperitoneal hematoma on CT scan L L L L L L
D. development of peritonitis on physical exam L L L L L
E. a fall in the hemoglobin level from 12 g/dL to 8 g/dL over 24 hours - ANSWER>>D.
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development of peritonitis on physical exam L L L L L
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EMS and found to be hypotensive with bradycardia and his abdomen is not distended.
L L L L L L L L L L L L L
He is disoriented and confused. He has a GCS of 9; his legs are warm and the pulses
L L L L L L L L L L L L L L L L L L
thready. His CVP is 9 his HR is 42 and his BP is 80/40. What is the most likely cause of his
L L L L L L L L L L L L L L L L L L L L L L
shock state? L
A. Closed head injury L L
B. Ongoing intra-abdominal hemorrhage L L
C. Pneumothorax
D. Neurogenic shock - ANSWER>>D. Neurogenic shock L L L L L
Which one of the following findings in an adult is most likely to require immediate
L L L L L L L L L L L L L L L
management during the primary survey? L L L L
A. distended abdomen L
B. Glasgow Coma Scale score of 11 L L L L L
C. temperature of 36.5°C (97.8°F) L L L
D. deforming of the right thigh L L L L
E. Respiratory rate of 40 breaths per minute - ANSWER>>E. Respiratory rate of 40
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breaths per minute L L
Which one of the following statements regarding abdominal trauma in the pregnant
L L L L L L L L L L L L
patient is TRUE? L L
A. The fetus is in jeopardy only with major abdominal trauma.
L L L L L L L L L
B. Leakage of amniotic fluid is an indication for hospital admission.
L L L L L L L L L
C. Indications for peritoneal lavage are different from those in the nonpregnant patient.
L L L L L L L L L L L
,D. With penetrating trauma injury to the mother's abdominal hollow viscus is more
L L L L L L L L L L L L
common in late than in early pregnancy.
L L L L L L
E. The secondary survey follows a different pattern from that of the nonpregnant
L L L L L L L L L L L L
patient. - ANSWER>>B. Leakage of amniotic fluid is an indication for hospital admission.
L L L L L L L L L L L L
The most important immediate step in the management of an open pneumothorax is:
L L L L L L L L L L L L
A. endotracheal intubation L
B. operation to close the wound L L L L
C. placing a chest tube through the chest wound
L L L L L L L
D. placement of an occlusive dressing over the wound L L L L L L L
E. initiation of 2 large-caliber IVs with crystalloid solutionE. - ANSWER>>D. placement of an
L L L L L L L L L L L L L
occlusive dressing over the wound
L L L L
The following are contraindications for tetanus toxoid administration:
L L L L L L L
A. history of neurological reaction or severe hypersensitivity to the product
L L L L L L L L L
B. local side effects
L L
C. muscular spasms L
D. pregnancy
E. all of the above - ANSWER>>A. history of neurological reaction or severe
L L L L L L L L L L L L
hypersensitivity to the product L L L
A 56-year-old man is thrown violently against the steering wheel of his truck during a
L L L L L L L L L L L L L L L
motor vehicle crash. On arrival in the emergency department he is diaphoretic and
L L L L L L L L L L L L L
complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40
L L L L L L L L L L L L L L L L L
breaths per minute. Which of the following best differentiates cardiac tamponade from
L L L L L L L L L L L L
tension pneumothorax as the cause of his hypotension?
L L L L L L L
A. Tachycardia
,B. pulse volume L
C. breath sounds L
D. pulse pressure L
E. jugular venous pressure - ANSWER>>C. breath sounds
L L L L L L
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
L L L L L L L L L L L L L L
endotracheal intubation because: L L
A. The trachea is relatively short.
L L L L
B. The distance from the lips to the larynx is relatively short.
L L L L L L L L L L
C. The use of cuffed endotracehal tubes eliminates this issue.
L L L L L L L L
D. The mainstem bronchi are less angulated in their relation to the trachea.
L L L L L L L L L L L
E. So little friction exists between the endotracheal tube and the wall of the trachea. -
L L L L L L L L L L L L L L L
ANSWER>>A. The trachea is relatively short. L L L L L
Which one of the following is the most effective method for initially treating frostbite?
L L L L L L L L L L L L L
A. moist heat L
B. early amputation
L
C. padding and elevation L L
D. vasodilators and heparin L L
E. topical application of silver sulfadiazine - ANSWER>>A. moist heat
L L L L L L L L
Which one of the following statements concerning intraosseous infusion is TRUE?A. Only
L L L L L L L L L L L L
crystalloid solutions may be safely infused through the needle.
L L L L L L L L
B. Aspiration of bone marrow confirms appropriate positioning of the needle.
L L L L L L L L L
C. Intraosseous infusion is the preferred route for volume resuscitation in small children.
L L L L L L L L L L L
, D. Intraosseous infusion may be utilized indefinitely. L L L L L
E. Swelling in the soft tissues around the intraosseous site is not a reason to discontinue
L L L L L L L L L L L L L L L
infusion. - ANSWER>>B. Aspiration of bone marrow confirms appropriate positioning of
L L L L L L L L L L L
the needle.
L
A young woman sustains a severe head injury as the result of a motor vehicle crash. In the
L L L L L L L L L L L L L L L L L L
emergency department her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart
L L L L L L L L L L L L L L L L
rate is 80 beats per minute. She is intubated and mechanically ventilated. Her pupils are 3
L L L L L L L L L L L L L L L L
mm in size and equally reactive to light. There is no other apparent injury. The most
L L L L L L L L L L L L L L L L
important principle to follow in the early management of her head injury is to:
L L L L L L L L L L L L L
A. avoid hypotension L
B. administer an osmotic diuretic L L L
C. aggressively treat systemic hypertension L L L
D. reduce metabolic requirements of the brain L L L L L
E. distinguish between intracranial hematoma and cerebral edema - ANSWER>>A. avoid
L L L L L L L L L L
hypotension
A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade III
L L L L L L L L L L L L L
(moderately severe) splenic injury has been confirmed by computed tomography (CT).
L L L L L L L L L L L
Which of the following mandates prompt celiotomy (laparotomy)?
L L L L L L L
A. a serum amylase of 200
L L L L L
B. a leukocyte count of 14,000
L L L L
C. evidence of retroperitoneal hematoma on CT scan L L L L L L
D. development of peritonitis on physical exam L L L L L
E. a fall in the hemoglobin level from 12 g/dL to 8 g/dL over 24 hours - ANSWER>>D.
L L L L L L L L L L L L L L L L L
development of peritonitis on physical exam L L L L L
