2022 EXAM FRO TCRN PRACTICE QUESTISONS WITH ANSWER ALL CORRECT
What blood component does not require ABO typing? Why? - CORRECT ANSWER Platelets - because it
part of the serum and does not have antibodies. Antigens are contained in the RBCs
What is the most common facial fracture? - CORRECT ANSWER Zygomatic bone check bone
In DIC is fibrinogen increased or decreased? - CORRECT ANSWER It will be decreased cause they are
being used up in the initial clot formation.
What are the 3 types of distributive shock? - CORRECT ANSWER Anaphlaxis, septic and Neurogenic
What are the 4 typesof shock? - CORRECT ANSWER Cardiogenic, Hypovolemic, Obstructive, Distributive
Who does obstructive shock affect more? - CORRECT ANSWER Pregnant woman from uterus pressure
on thoracic cavity
What is the purpose of glucose stores in the liver - CORRECT ANSWER It is utilized in fight section of fight
or flight to boost energy.
When glucose is high what are some complications of to blood componenets? - CORRECT ANSWER the
WBS/Neutrophils are paralyzed about 120 mg'dl
What is automaticity of the heart? - CORRECT ANSWER It the speed of the electricity in the heart
What does an increase of automaticity tend to cause? - CORRECT ANSWER Arrthymias
What do inflammatory mediators cause - CORRECT ANSWER systemic vasodilation to flood the area with
RBS,WBS and O2
What is the pulse pressure ? - CORRECT ANSWER Systolic minus diastolic
What is the systolic blood pressure? - CORRECT ANSWER The squeeze of teh ventricles
What is the diastolic blood pressure? - CORRECT ANSWER the peripheal blood pressure or vascular
resistance
What is sterlings law? - CORRECT ANSWER The further soomething streches the stronger the contraction
How do you calculate MAP? - CORRECT ANSWER diastolic x2 plus (+) systolic divided by 3
Why would not place an IO in a certain bone? - CORRECT ANSWER Fracture in bone or previous failed
attempts in same bone
What is the calculation for pediataric fluid bolus ? - CORRECT ANSWER 20 cc/kg
,What do colloids do? - CORRECT ANSWER Bring large fluid in into the cell as they are plasma based
molecules such as albumin.
Why do you add blood in a trauam resusitation after fluids? - CORRECT ANSWER Fluids do not carry
oxygen but RBCs do.
What are the other lab levels for DIC? - CORRECT ANSWER Plts dec
PT/PTT increased longer bleeding times clot factors used up
Fibronogen dec used to form clots
Ddimer increased its a clot degradation product
Hct/Hgb dec as the patient is bleeding
What is whole blood and how long is ot good for? - CORRECT ANSWER Whole blood contains all of the
blood compenents and must be used up quickly no additives to prevents clots from forming. Usually
bagged in 500cc bags
How much does each unit of PRBCs increase labs? - CORRECT ANSWER 1 g/l Hgb and 3% Hct
What is th unit size for an order of PRBCs? - CORRECT ANSWER 250 cc
One unit of platelets increase serum level by how much? - CORRECT ANSWER 5-10K you will be giving
multiple units
Where are most clotting factors located in blood? - CORRECT ANSWER Fresh Frozen Plasma
Each unit of FFP increases serum by hw much? - CORRECT ANSWER 7%
What are cryoprecipitates? - CORRECT ANSWER Respun FFP - WBC make be leukoreduced
What is the universal blood donor? - CORRECT ANSWER O - use O - in females or O+ in males
What s the universsal donor for fresh frozen plasma? - CORRECT ANSWER AB blood no antibodies
In large blood transfusions what electrolytes do you watch closely? - CORRECT ANSWER Potassion Hyper
K+ (lysis), Calcium HypoCa+ (10 plus units anti coag additives), acidosis from sitting o n shelf, Coag -
giving PBRCs without clotting factors
What is permissive hypotension? - CORRECT ANSWER Allowing the BP to be lower as to not blow a
formed clot
What type of injury is permissive hypotension best for? - CORRECT ANSWER penetration not so much fro
blunt, or head injury. elderly or ped
What are some end points of resuscitation? - CORRECT ANSWER Lactate < 4mmol/l anarobic use for
energy
Base deficiet < 4 (blood buffer) 4 means widespread hypoperfusion
, Why are BP, mental status, and urine output not great indicators of end points for resuscitation? -
CORRECT ANSWER BP - non predictive of end tissure perfusion
Mental - drug etoh use prior
Urinary - Consider comorbids DM, CRF, lasix
Why are invasive hemodynamic monitors NOT best for end point resuscitation? - CORRECT ANSWER Risk
of infection
What are the parametrs for base defieciet? - CORRECT ANSWER 4 wide spread hypoperfusin
6 severe injury
What is neurogenic shock? - CORRECT ANSWER failure of the sympathetic system - involves widespread
vasodilation
Where does injury tnd to occur in neurogenic shock? - CORRECT ANSWER T4-T6 and above
What are symptoms of neurgenic shock? - CORRECT ANSWER Bradycardia, decreased contracility,
decreased automaticity, decreased respiratory, dry skin, cholinergic reaction
What do use to treat neurogenic shock? - CORRECT ANSWER vaso pressors - dopamin, NorEpi, Epi,
Phenal, vasopressin
What do you want the MAP at for neuro shock? - CORRECT ANSWER 85-90 mmHg
In Neuro shick what do you treat the brady cardia with ? - CORRECT ANSWER Atropine
What is SIRS? - CORRECT ANSWER systemic inflammatory response syndrome, if infection in blood the
inflammatory mediators will show up in the blood too causeing more damamge
What are some diagnosis factors of SIRS - CORRECT ANSWER temp > 38, HR >90, resp > 20 , AMS, inc
WBC >12 or < 4k BS greater than 120
IS bacteria the only thing to cause SIRS? - CORRECT ANSWER Nope - severe injury crush, pelvic, femaoral
injuries
Is trauma designation states or college level? - CORRECT ANSWER State level
Trauma verification is done by whom? - CORRECT ANSWER American College of Surgeons
What must all trauma centers have - CORRECT ANSWER A performance improvement
What does TRISS stand for - CORRECT ANSWER Trauma Injury severity score
What are the 4 components of TRISS - CORRECT ANSWER Age
MOi
Triage level
revised trauam score
What blood component does not require ABO typing? Why? - CORRECT ANSWER Platelets - because it
part of the serum and does not have antibodies. Antigens are contained in the RBCs
What is the most common facial fracture? - CORRECT ANSWER Zygomatic bone check bone
In DIC is fibrinogen increased or decreased? - CORRECT ANSWER It will be decreased cause they are
being used up in the initial clot formation.
What are the 3 types of distributive shock? - CORRECT ANSWER Anaphlaxis, septic and Neurogenic
What are the 4 typesof shock? - CORRECT ANSWER Cardiogenic, Hypovolemic, Obstructive, Distributive
Who does obstructive shock affect more? - CORRECT ANSWER Pregnant woman from uterus pressure
on thoracic cavity
What is the purpose of glucose stores in the liver - CORRECT ANSWER It is utilized in fight section of fight
or flight to boost energy.
When glucose is high what are some complications of to blood componenets? - CORRECT ANSWER the
WBS/Neutrophils are paralyzed about 120 mg'dl
What is automaticity of the heart? - CORRECT ANSWER It the speed of the electricity in the heart
What does an increase of automaticity tend to cause? - CORRECT ANSWER Arrthymias
What do inflammatory mediators cause - CORRECT ANSWER systemic vasodilation to flood the area with
RBS,WBS and O2
What is the pulse pressure ? - CORRECT ANSWER Systolic minus diastolic
What is the systolic blood pressure? - CORRECT ANSWER The squeeze of teh ventricles
What is the diastolic blood pressure? - CORRECT ANSWER the peripheal blood pressure or vascular
resistance
What is sterlings law? - CORRECT ANSWER The further soomething streches the stronger the contraction
How do you calculate MAP? - CORRECT ANSWER diastolic x2 plus (+) systolic divided by 3
Why would not place an IO in a certain bone? - CORRECT ANSWER Fracture in bone or previous failed
attempts in same bone
What is the calculation for pediataric fluid bolus ? - CORRECT ANSWER 20 cc/kg
,What do colloids do? - CORRECT ANSWER Bring large fluid in into the cell as they are plasma based
molecules such as albumin.
Why do you add blood in a trauam resusitation after fluids? - CORRECT ANSWER Fluids do not carry
oxygen but RBCs do.
What are the other lab levels for DIC? - CORRECT ANSWER Plts dec
PT/PTT increased longer bleeding times clot factors used up
Fibronogen dec used to form clots
Ddimer increased its a clot degradation product
Hct/Hgb dec as the patient is bleeding
What is whole blood and how long is ot good for? - CORRECT ANSWER Whole blood contains all of the
blood compenents and must be used up quickly no additives to prevents clots from forming. Usually
bagged in 500cc bags
How much does each unit of PRBCs increase labs? - CORRECT ANSWER 1 g/l Hgb and 3% Hct
What is th unit size for an order of PRBCs? - CORRECT ANSWER 250 cc
One unit of platelets increase serum level by how much? - CORRECT ANSWER 5-10K you will be giving
multiple units
Where are most clotting factors located in blood? - CORRECT ANSWER Fresh Frozen Plasma
Each unit of FFP increases serum by hw much? - CORRECT ANSWER 7%
What are cryoprecipitates? - CORRECT ANSWER Respun FFP - WBC make be leukoreduced
What is the universal blood donor? - CORRECT ANSWER O - use O - in females or O+ in males
What s the universsal donor for fresh frozen plasma? - CORRECT ANSWER AB blood no antibodies
In large blood transfusions what electrolytes do you watch closely? - CORRECT ANSWER Potassion Hyper
K+ (lysis), Calcium HypoCa+ (10 plus units anti coag additives), acidosis from sitting o n shelf, Coag -
giving PBRCs without clotting factors
What is permissive hypotension? - CORRECT ANSWER Allowing the BP to be lower as to not blow a
formed clot
What type of injury is permissive hypotension best for? - CORRECT ANSWER penetration not so much fro
blunt, or head injury. elderly or ped
What are some end points of resuscitation? - CORRECT ANSWER Lactate < 4mmol/l anarobic use for
energy
Base deficiet < 4 (blood buffer) 4 means widespread hypoperfusion
, Why are BP, mental status, and urine output not great indicators of end points for resuscitation? -
CORRECT ANSWER BP - non predictive of end tissure perfusion
Mental - drug etoh use prior
Urinary - Consider comorbids DM, CRF, lasix
Why are invasive hemodynamic monitors NOT best for end point resuscitation? - CORRECT ANSWER Risk
of infection
What are the parametrs for base defieciet? - CORRECT ANSWER 4 wide spread hypoperfusin
6 severe injury
What is neurogenic shock? - CORRECT ANSWER failure of the sympathetic system - involves widespread
vasodilation
Where does injury tnd to occur in neurogenic shock? - CORRECT ANSWER T4-T6 and above
What are symptoms of neurgenic shock? - CORRECT ANSWER Bradycardia, decreased contracility,
decreased automaticity, decreased respiratory, dry skin, cholinergic reaction
What do use to treat neurogenic shock? - CORRECT ANSWER vaso pressors - dopamin, NorEpi, Epi,
Phenal, vasopressin
What do you want the MAP at for neuro shock? - CORRECT ANSWER 85-90 mmHg
In Neuro shick what do you treat the brady cardia with ? - CORRECT ANSWER Atropine
What is SIRS? - CORRECT ANSWER systemic inflammatory response syndrome, if infection in blood the
inflammatory mediators will show up in the blood too causeing more damamge
What are some diagnosis factors of SIRS - CORRECT ANSWER temp > 38, HR >90, resp > 20 , AMS, inc
WBC >12 or < 4k BS greater than 120
IS bacteria the only thing to cause SIRS? - CORRECT ANSWER Nope - severe injury crush, pelvic, femaoral
injuries
Is trauma designation states or college level? - CORRECT ANSWER State level
Trauma verification is done by whom? - CORRECT ANSWER American College of Surgeons
What must all trauma centers have - CORRECT ANSWER A performance improvement
What does TRISS stand for - CORRECT ANSWER Trauma Injury severity score
What are the 4 components of TRISS - CORRECT ANSWER Age
MOi
Triage level
revised trauam score
