MEDICINE 108 4 post test
1. The primary indication for transferring 4. Which one of the following s
a regarding patients with thoracic
patient to a higher level trauma center is: TRUE?
unavailability of a surgeon or operating room Log-rolling may be des
staff. fractures from T
multiple system injuries, including severe Adequate immobilizat
head injury. accomplished with the scoop
resource limitations as determined by Spinal cord injury below T-10 usua
the bowel and bladde
transferring doctor. Hyperflexion fractures in
resource limitations as determined by the thoracic spine are inherently
hospital administration. These patients rarely present
widened mediastinum on chest x-ray shock in association with c
following blunt thoracic trauma.
5. young man sustains a ritle wo
2. teen-aged bicycle rider is hit by a truck abdomen. He is brought promp
traveling at a high rate of speed. In the emergency department by preh
emergency department, she is actively personnel. His skin is cool and
bleeding from open fractures of her legs, and his systolic blood pressure is 58
has abrasions on her chest and abdominal wall. Warmed crystalloid fluids are in
Her improvement in his vital sig
blood pressure is 80/50 mm Hg, heart rate is most appropriate step is to perf
140 beats per minute, respiratory rate is 8 a
breaths per minute, and GCS score is 6. an abdomin
diagnostic lap
The first step in managing this patient is
abdominal ultras
to: a diagnostic periton
obtain a lateral cervical spine x-ray.
insert a central venous pressure line. 6. young woman sustains a seve
administer 2 liters of crystalloid solution.
perform endotracheal intubation as the result of a motor vehicul
and emergency department, her GC
ventilation. Her
apply the PASG and inflate the leg blood pressure is 140/90 mm H
compartments.
rate is 80 beats per minute. She
and is being mechanically vent
3. Contraindication to nasogastric intubation is
pupils are 3 mm in size and equ
the presence of a:
light.
gastric perforation.
There is no other apparent injur
diaphragmatic rupture.
important principle to follow in
, aggressively treat systemic hypertension. 9. 8-year-old girl is an unrestrai
reduce metabolic requirements of the
brain. in a vehicle struck from behind.
distinguish between intracranial hematoma emergency department, her blo
and cerebral edema. 80/60 mm Hg, heart rate is 80 b
and respiratory rate is 16 breath
7. 22-year-old man is brought to the hospital Her GCS score is 14. She compl
after crashing his motorcycle into a telephone legs feel "funny and won't mov
pole. He is unconscious and in profound however, her spine x-rays do n
shock. He has no open wounds or obvious fracture or dislocation. A spina
fractures. this child:
The cause of his shock is MOST LIKELY is most likely a central cord
caused by: must be diagnosed by magnetic
a subdural hematoma. can be excluded by obtainin
an epidural hematoma.
a transected lumbar spinal cord. ent
a transected cervical spinal cord. may exist in the absence o
hemorrhage into the chest or findings on x-ra
abdomen. is unlikely because of the
calcification of the verteb
8. 30-year-old man is struck by a car traveling 10. Immediate chest tube inserti
at 56 kph (35 mph). He has obvious fractures for which of the following cond
of the left tibia near the knee, pain in the Pneu
pelvic area, and severe dyspnea. His heart rate Pneumom
Massive h
is 180
Diaphragma
beats per minute, and his respiratory rate is 48 Subcutaneous e
breaths per minute with no breath sounds heard
in the left chest. A tension pneumothorax is
11. 18-year-old, helmeted motor
relieved by immediate needle decompression
brought by ambulance to the e
and tube thoracostomy. Subsequently, his heart
department following a high-sp
rate decreases to 140 beats per minute, his
Prehospital persormel report tha
respiratory rate decreases to 36 breaths per
15 meters (50 feet) off his bfice
minute, and his blood pressure is 80/50 inm Hg.
history of hypotension prior to
Warmed Ringer's lactate is administered
emergency department, but is n
intravenously. The next priority should be to:
perform a urethrogram and cystogram. and conversational. Which of t
perform external fixation of the pelvis. statements is TRUE?
obtain abdominal and pelvic CT scans.
perform arterial embolization of the
pelvic
vessels.
, Intraabdominal visceral injuries are
defmitive treatment in managin
unlikely.
to:
The patient probably has an acute
administer 0-negat
epidural hematoma. apply extemal warm
control internal hemorrhage
apply the pneumatic antishoc
12. crosstable, lateral x-ray of the cervical infuse large volumes of in
spine: crystalloid
must precede endotracheal intubation.
excludes serious cervical spine injury. 16. To establish a diagnosis of sh
is an essential part of the primary survey. systolic blood pressure must be
is not necessary for unconscious patients
with penetrating cervical injuries. the presence of a closed head in
be
is unacceptable unless 7 cervical vertebrae acidosis should be present by arte
\ga
and the C-7 to T-1 relationship are the patient must fail to r
visualized. intravenous fluid
clinical evidence of inadeq
perfusion must b
13. During resuscitation, which one of the
following is the most reliable as a guide
to volume replacement? 17. Absence of breath sounds an
Pulse rate percussion over the left hemith
Hematocrit best explained by:
Blood pressure left he
Urinary output
cardiac
Jugular venous pressure left simple pneu
left diaphragmat
right tension pn
14. Which one of the following is the
recommended method for initially
treating frostbite? 18. 17-year-old helmeted motor
Vasodilators
broadside by an automobile at a
Anticoagulants He is unconscious at the scene
Warm (40°C) water
pressure of 140/90 mm Hg, hea
Padding and elevation
beats per minute, and respirator
Topical application of silvasulphadiazine
breaths per minute. His respirat
sonorous and deep. His GCS sc
15. young man sustains a gunshot wound to the Immobilization of the entire pa
abdomen and is brought promptly to the include the use of all the follow
emergency department by prehospital
personnel. His skin is cool and diaphoretic, and
1. The primary indication for transferring 4. Which one of the following s
a regarding patients with thoracic
patient to a higher level trauma center is: TRUE?
unavailability of a surgeon or operating room Log-rolling may be des
staff. fractures from T
multiple system injuries, including severe Adequate immobilizat
head injury. accomplished with the scoop
resource limitations as determined by Spinal cord injury below T-10 usua
the bowel and bladde
transferring doctor. Hyperflexion fractures in
resource limitations as determined by the thoracic spine are inherently
hospital administration. These patients rarely present
widened mediastinum on chest x-ray shock in association with c
following blunt thoracic trauma.
5. young man sustains a ritle wo
2. teen-aged bicycle rider is hit by a truck abdomen. He is brought promp
traveling at a high rate of speed. In the emergency department by preh
emergency department, she is actively personnel. His skin is cool and
bleeding from open fractures of her legs, and his systolic blood pressure is 58
has abrasions on her chest and abdominal wall. Warmed crystalloid fluids are in
Her improvement in his vital sig
blood pressure is 80/50 mm Hg, heart rate is most appropriate step is to perf
140 beats per minute, respiratory rate is 8 a
breaths per minute, and GCS score is 6. an abdomin
diagnostic lap
The first step in managing this patient is
abdominal ultras
to: a diagnostic periton
obtain a lateral cervical spine x-ray.
insert a central venous pressure line. 6. young woman sustains a seve
administer 2 liters of crystalloid solution.
perform endotracheal intubation as the result of a motor vehicul
and emergency department, her GC
ventilation. Her
apply the PASG and inflate the leg blood pressure is 140/90 mm H
compartments.
rate is 80 beats per minute. She
and is being mechanically vent
3. Contraindication to nasogastric intubation is
pupils are 3 mm in size and equ
the presence of a:
light.
gastric perforation.
There is no other apparent injur
diaphragmatic rupture.
important principle to follow in
, aggressively treat systemic hypertension. 9. 8-year-old girl is an unrestrai
reduce metabolic requirements of the
brain. in a vehicle struck from behind.
distinguish between intracranial hematoma emergency department, her blo
and cerebral edema. 80/60 mm Hg, heart rate is 80 b
and respiratory rate is 16 breath
7. 22-year-old man is brought to the hospital Her GCS score is 14. She compl
after crashing his motorcycle into a telephone legs feel "funny and won't mov
pole. He is unconscious and in profound however, her spine x-rays do n
shock. He has no open wounds or obvious fracture or dislocation. A spina
fractures. this child:
The cause of his shock is MOST LIKELY is most likely a central cord
caused by: must be diagnosed by magnetic
a subdural hematoma. can be excluded by obtainin
an epidural hematoma.
a transected lumbar spinal cord. ent
a transected cervical spinal cord. may exist in the absence o
hemorrhage into the chest or findings on x-ra
abdomen. is unlikely because of the
calcification of the verteb
8. 30-year-old man is struck by a car traveling 10. Immediate chest tube inserti
at 56 kph (35 mph). He has obvious fractures for which of the following cond
of the left tibia near the knee, pain in the Pneu
pelvic area, and severe dyspnea. His heart rate Pneumom
Massive h
is 180
Diaphragma
beats per minute, and his respiratory rate is 48 Subcutaneous e
breaths per minute with no breath sounds heard
in the left chest. A tension pneumothorax is
11. 18-year-old, helmeted motor
relieved by immediate needle decompression
brought by ambulance to the e
and tube thoracostomy. Subsequently, his heart
department following a high-sp
rate decreases to 140 beats per minute, his
Prehospital persormel report tha
respiratory rate decreases to 36 breaths per
15 meters (50 feet) off his bfice
minute, and his blood pressure is 80/50 inm Hg.
history of hypotension prior to
Warmed Ringer's lactate is administered
emergency department, but is n
intravenously. The next priority should be to:
perform a urethrogram and cystogram. and conversational. Which of t
perform external fixation of the pelvis. statements is TRUE?
obtain abdominal and pelvic CT scans.
perform arterial embolization of the
pelvic
vessels.
, Intraabdominal visceral injuries are
defmitive treatment in managin
unlikely.
to:
The patient probably has an acute
administer 0-negat
epidural hematoma. apply extemal warm
control internal hemorrhage
apply the pneumatic antishoc
12. crosstable, lateral x-ray of the cervical infuse large volumes of in
spine: crystalloid
must precede endotracheal intubation.
excludes serious cervical spine injury. 16. To establish a diagnosis of sh
is an essential part of the primary survey. systolic blood pressure must be
is not necessary for unconscious patients
with penetrating cervical injuries. the presence of a closed head in
be
is unacceptable unless 7 cervical vertebrae acidosis should be present by arte
\ga
and the C-7 to T-1 relationship are the patient must fail to r
visualized. intravenous fluid
clinical evidence of inadeq
perfusion must b
13. During resuscitation, which one of the
following is the most reliable as a guide
to volume replacement? 17. Absence of breath sounds an
Pulse rate percussion over the left hemith
Hematocrit best explained by:
Blood pressure left he
Urinary output
cardiac
Jugular venous pressure left simple pneu
left diaphragmat
right tension pn
14. Which one of the following is the
recommended method for initially
treating frostbite? 18. 17-year-old helmeted motor
Vasodilators
broadside by an automobile at a
Anticoagulants He is unconscious at the scene
Warm (40°C) water
pressure of 140/90 mm Hg, hea
Padding and elevation
beats per minute, and respirator
Topical application of silvasulphadiazine
breaths per minute. His respirat
sonorous and deep. His GCS sc
15. young man sustains a gunshot wound to the Immobilization of the entire pa
abdomen and is brought promptly to the include the use of all the follow
emergency department by prehospital
personnel. His skin is cool and diaphoretic, and
