PHTLS EXAM WITH CORRECT ANSWERS

PHTLS EXAM WITH CORRECT ANSWERS When the application of kinetic to the body from either a blunt or penetrating mechanism displaces tissue, this is known as - ANSWER- CAVITATION Which of the following is an example of the tertiary phase blast injury? - ANSWER- CRUSHING INJURY DUE TO STRUCTURAL COLLAPSE. The most common threat to life among trauma patients is? - ANSWER- INTERNAL HEMORRHAGE Your patient is an injured construction worker bleeding profusely from a large laceration to the left thigh. He is confused and has pale, moist skin. Direct pressure applied to the wound by a first responder has failed to control the bleeding. The next step in controlling bleeding is to apply: - ANSWER- A TOURNIQUET TO THE LACERATION. Hypotension due to spinal cord trauma occurs due to interruption of the _______________nervous system pathway. - ANSWER- SYMPATHETIC The most common fractured ribs are ribs: - ANSWER- 4 THROUGH 8. A hemothorax is differentiated from a tension pneumothorax by: - ANSWER- DULL PERCUSSION ON THE AFFECTED SIDE. Which of the following mechanisms is most likely to result in cardiac tamponade? - ANSWER- A PATIENT IS STRUCK IN THE LEFT ANTERIOR CHEST BY A NAIL EJECTED FROM A NAIL GUN. Management of flail chest includes: - ANSWER- PAIN MANAGEMENT VENTILATORY SUPPORT 100%O2 Which of the following types of traumatic brain injury is most likely to be associated with hemorrhage from the middle meningeal artery? - ANSWER- EPIDURAL HEMATOMA Which of the following groups of findings represents Cushing's phenomenon? - ANSWER- BRADYCARDIA ABNORMAL RESPIRATORY PATTERN ELEVATED BLOOD PRESSURE Your patient is a 32 year old female who was thrown from a horse and struck her head on the ground. She was not wearing a helmet. She does not respond verbally or open her eyes to painful stimuli, but responds to painful stimuli with decerebrate posturing. Her right pupil is dilated and does not react to light. Her respirations are 6 per minute and irregular, pulse 56, blood pressure 188/98. You should ventilate the patient at a rate of? - ANSWER- 20 BPM. A burn with reddened, glistening base that may have blisters is most characteristic of a - ANSWER- SECOND degree burn. A chemical solution with a pH of 4.0 is considered an ACID and causes damage to the tissues via - ANSWER- COAGULATION NECROSIS. An electrical burn caused by superheated air near the source of electricity is an - ANSWER- ARC burn. Your patient is an 82 year old female who was an unrestrained front seat passenger in a motor vehicle collision. Which of the following is the most reliable indication of shock in this patient? - ANSWER- LEVEL OF CONSCIOUSNESS. Which of the following findings is not expected in assessment of a pregnant patient? - ANSWER- A DECREASED BLOOD PRESSURE IN THE THIRD TRIMESTER. Which of the following is contraindicated in the management of a pregnant trauma patient in the third trimester? - ANSWER- SUPINE POSITION. During the assessment of the trauma patient, auscultation of the lung sounds is first performed during: - ANSWER- THE PRIMARY SURVEY. Which of the following is indicated for the prehospital management of a circumferential second degree burn extending from the wrist to the elbow in a 70 Kg patient? - ANSWER- A DRY STERILE DRESSING ANALGESIA The preferred fluid for resuscitation of the patient with significant burns is: - ANSWER- LACTATED RINGER'S SOLUTION. Which of the following is the most common cause of spinal injuries? - ANSWER- MOTOR VEHICLE COLLISIONS. Hypotension in hemothorax is associated with: - ANSWER- THE ABILITY OF EACH SIDE OF THE THORAX TO HOLD UP TO 3 LITERS OF BLOOD. Cardiac tamponade is suspected with the findings of muffled heart sounds___________, and___________ known as___________. - ANSWER- JUGULAR VEIN DISTENTION, and HYPOTENSION, known as BECK'S TRIAD. When administering isotonic crystalloid solution, about ___________ will remain in the vascular system after 1 hour. - ANSWER- ONE-THIRD PASG is contraindicated in patients with - ANSWER- CHEST TRAUMA. The greatest threat to life from injury to hollow abdominal organ is - ANSWER- PERITONITIS. IV fluids administered to patients in shock should be _______ in order to ______________ ______________. - ANSWER- WARM, PREVENT HYPOTHERMIA. During pregnancy, signs and symptoms of shock may appear _______ due to an _________ in maternal blood volume. - ANSWER- LATER, INCREASE A fractured femur can result in___________________mL of hemorrhage. - ANSWER- 1000 TO 2000 A male patient suffered a stab wound to his left flank. He is found to be in stage III shock. During the 25 minute transport to the trauma center, intravenous fluids should be administered at a rate sufficient to maintain a: - ANSWER- SYSTOLIC BP OF 80 TO 90. The most common type of shock in trauma patients is - ANSWER- HYPOVOLEMIC. What percentage of blood volume loss in an adult patient is associated with findings of tachycardia (120/beats/minute), tachypnea (30-40 Breaths/min), and hypotension (systolic BP 90mmHg)? - ANSWER- 30 TO 40 Minute volume of ventilation is best represented as - ANSWER- TIDAL VOLUME x ventilatory rate Which injury is most likely to be sustained by the driver in a lateral impact collision to the left side of the vehicle with no side impact airbags (assuming the driver sits on the left)? - ANSWER- FRACTURED LEFT CLAVICLE. Give me the general ideas of trauma criteria? - ANSWER- Any patient that has a compromise to Airway, Breathing, Circulation and Deficit. Any Patient that is Altered or What three areas of a penetrating injury would be trauma criteria? - ANSWER- Thoracic cavity and up. Cranial, between Thoracic and midclavicular line, neck. For trauma criteria what must the BP be below in an adult? Child? - ANSWER- Adult 90 / Child 70 (Systolic) What is the trauma criteria for blunt head injury? - ANSWER- ALOC, GCS less than 14, except pt. 1 y/o, seizures, unequal pupils, or focal neurological deficit. For trauma criteria what should also be present in a Cardiac arrest? - ANSWER- Penetrating torso trauma. What is the most common threat to life? - ANSWER- Inadequate tissue perfusion When would a shotgun injury meet trauma criteria? - ANSWER- wounds to the trunk. A fall from 15 feet is trauma criteria so what type of injuries may also be sustained that APPLY to trauma criteria? - ANSWER- Blunt chest injury- flail chest, abdominal tenderness, spinal fx w/ extremity weakness and sensory deficit. If the driver of a vehicle is found in the passenger space can't feel his toes and has no radial pulse in left extremity is this patient trauma criteria? How many categories does this patient fall into? - ANSWER- yes/3. Name some guidelines for trauma patients? transport is advised. - ANSWER- Surviving patients in MVC where fatalities and complaint of injury occur- Pedestrian vs Auto.- ejection from vehicle, extrication, young and old patients w/ medical history What are indications of use of a PASG? - ANSWER- suspected pelvic fx- profound hypotension (sys 50 to 60)- retroperitoneal hemorrhage. What are CONTRAindications of use of a PASG? - ANSWER- Penetrating thoracic trauma- splinting of lower extremity fx.- Eviceration of abdominal organs, impaled objects in abdomen- Pregnancy- traumatic cardiac arrest. When using a PASG what syndrome will occur if you decide to splint a lower extremity? - ANSWER- compartment syndrome. What is a Colles fracture? - ANSWER- bilateral fracture of wrist- fall w/ outstretched hands What is Don Juan syndrome? - ANSWER- bilateral heel/ankles/ tib. Fib./Femur/pelvic fall on feet. What are early signs of increase intracranial pressure? - ANSWER- headache and vomiting At what height are falls the most significant? - ANSWER- 15 feet In trauma what's the difference between hollow and solid organs? - ANSWER- hollow causes peritonitis - solid organs bleed. What injuries would occur at the time of impact? - ANSWER- crush or compression injuries. What is the first action with a severe burn patient? - ANSWER- stop the burning. When there is a decrease in intravenous pressure what are common S/S? - ANSWER- JVD When the acute physiologic and structural change occurs in a patient's body when an external source of energy dissipates faster than the bodies ability to sustain and dissipate it? - ANSWER- trauma Kehr's sign is associated with what organ? - ANSWER- spleen When giving analgesic therapy what is the goal in prehospital care? - ANSWER- diminish pain to a tolerable level (control not abuse) What medication may cause a delay in healing? - ANSWER- corticosteroid What is the best treatment for commotio cortis? - ANSWER- CPR and AED What kind of hypovolemic shock comes from external bleeding? - ANSWER- exogenous hypovolemic shock What is the first action for external bleeding? - ANSWER- direct pressure and elevation. Compartment syndrome can occur in what type of injuries? - ANSWER- Closed Injuries What is the difference between retrograde and antegrade amnesia? - ANSWER- retro- is cant remember before- ante- cant remember after. When a patient has chemical burns to the eyes what is the treatment? - ANSWER- Constant flushing with IV fluid and continuous irrigation. What are the most critical burn patients? - ANSWER- Patients with a significant