TCAR EXAM STUDY GUIDE 2026/2027 COMPLETE QUESTIONS AND VERIFIED CORRECT SOLUTIONS || ALREADY GRADED A+ RECENT VERSION

TCAR EXAM STUDY GUIDE 2026/2027 COMPLETE QUESTIONS AND VERIFIED CORRECT SOLUTIONS || ALREADY GRADED A+ RECENT VERSION 1. 3 questions to ask in trauma - ANSWER -what was the dose of energy? -where did it go? -what injuries are likely? 2. 2 q's to ask in GSW - ANSWER caliber type of gun # of entrance/exit wounds high/low velocity 3. 1st question to ask in any traumatic injury? - ANSWER what was the dose of energy involved? (was it high or low?) 4. what is the caliber of a bullet? - ANSWER diameter 5. aka diameter of a bullet - ANSWER caliber 6. what happens to projectiles when they enter the body - ANSWER projectiles don't travel in a straight line consider temporary cavity wound 7. what should you consider about tissue a projectile enounters - ANSWER temporary cavitation 8. primary goal of GSW surgery - ANSWER usually damage repair & not bullet removal -if superficial, it may migrate the surface with time 9. important thing to remember about retained projectiles - ANSWER they may migrate over time. bullett migration might explain unexplained clinical findings 10. (VP Cheney accidentally shot his friend while hunting in 2006. ICU and did great. moved to an inpatient unit. had a silent MI bc a shot gun pellets migrated into a canary artery causing an infract. so had a MI but fibrinolytic not the answer in this case b/c it was a "projectile embolus" 11. aka brestbone - ANSWER sternum 12. what attaches the ribs to the sternum - ANSWER cartliage 13. what breaks thoracic bones - ANSWER significant force -1-2nd ribs, posterior ribs, sternum, scapulae, T2-10 gives us info about the force aka "dose" of energy received consider injury to internal structures b/c force 14. ribs that are the most frequently broken - ANSWER ribs 4-9 b/c long, thin, and poorly protecte it is harder to break a short pencil (T1-2) and easier to break a longer one *ask how many and where to understand the force involved 15. what does diffuse axonal injury represent - ANSWER suggests deliberate trauma - probably not an accident 16. pathology of diffuse axonal injury - ANSWER axons are disrupted at the time of injury or in the following hours "disconnecting from the brain" **immediate LOC**  effect is similiar to yanking out a computer cord. it immediately turns off and doesn't turn back on  torn axons dont' regenerate and don't come back *no putting the brian back together and it cain't recover *cause of vegetative state in TBI 17. cause of vegetative state in TBI - ANSWER diffuse axonal injury immediate LOC like you yanked out the computer cord. it immediately turns off and does not turn back on 18. brain injury that is similar to yanking out a computer cord - ANSWER diffuse axonal injury. immediate LOC. like yanking out a computer cord and it will never turn back on 19. causes of brain injury leading to vegetative state - ANSWER TBI/trauma = diffuse axonal injury medical cause = anoxia 20. CT in diffuse axonal injury - ANSWER initial CT of diffuse axonal injury is usually normal b/c the damage is initially microscopic -50-80% of DAI has no early CT findings. hours later, edema is present. peak of edema in 2 days 21. second impact syndrome - ANSWER aka "diffuse cerebral swelling" 1st confussion injury new injury later (minutes-days.. later. pt collapses from a new injury to the brain (even if minor) tha tleads to massive cerebral edema that herniates. 100% either die or have major deficits 22. concussion injury then another head injury even minor later that leads to herniation - ANSWER second impact syndrome aka diffuse cerebral swelling 23. cumultative trauma to the brain from repeated blows - ANSWER chronic traumatic encephalopathy (CTE) 24. Chronic Traumatic Encephalopathy (CTE) - ANSWER Cumulative damage resulting from repeated brain injuries 25. types of diffuse brain injuries - ANSWER concussion diffuse axonal injury hypoxic/ischemic brain injuries *directly affects consciousness 26. types of focal brain injury - ANSWER indirectly affects conciousness. can point to the exact spot on CT *skull fracture epidural/subdural hemaotoma concussion 27. there are only two ways to drop H and H levels, what are they? - ANSWER 1. dilute the blood with IV fluids 2. fluid compartment shift 28. if a patient bleeds out quickly what will their hemoglobin level be? Low, normal, or high? - ANSWER normal! 29. shock is a state in which.... - ANSWER cellular metabolic oxygen demand exceeds supply 30. when a patient is hypovolemic, one way to compensate for the decrease in intravascular fluid is to increase water reabsorption in the kidneys. which two processes occur to achieve this? - ANSWER ADH release from the posterior pituitary gland to the kidneys, and RAAS 31. The role of inflammation in traumatic shock is complex and incompletely understood. However, inflammatory mediators both hyperstimulate and suppress immune function. Although inflammatory responses are present shortly after injury, they are chiefly important in the post-resuscitative period, where they influence SIRS and impact healing. - ANSWER 32. Ventilation is the initial step in the tissue oxygenation cascade. But getting oxygen into the lungs isn't enough. It must diffuse through the alveoli to the capillaries. Diffusion isn't helpful unless there's adequate hemoglobin available to pick up the oxygen once it's passed through the alveoli. And hemoglobin does no good unless there's sufficient cardiac output to send oxygenated red cells to where they need to go. The final step in the tissue oxygenation cascade-and the only one that counts in the end-is tissue oxygen utilization. Can the cells both get and use the delivered oxygen? - ANSWER ventilation --- diffusion--- hemoglobin availability ----- cardiac output ---- tissue oxygen utilization 33. pulmonary contusions can cause... - ANSWER damage to the capillaries and alveoli which can cause issues with diffusion and there for.... oxygenation 34. which parameter do we use to measure a patients ventilation status? saturation / SpO2