1. All of the following signs on the chest x-ray of a patient who sustained a blunt injury
maysuggest aortic rupture except which one?
a. mediastinal emphysema
b. presence of a pleural cap
c. obliteration of the aortic knob
d. deviation of the trachea to the right
e. depression of the left mainstem bronchus
2. A 30-year-old woman fell down four stairs landing on concrete. Witnesses report she
was unconscious for five minutes beginning immediately after the fall. She regained
full consciousness during the ten minute transport to the hospital. Upon arrival in the
emergency department, she is awake, alert, and responsive with a Glasgow Coma Scale
score of 15. Her only complaint is a slight headache. Thirty minutes later, she becomes
unresponsive with a Glasgow Coma Scale score of 6. On the exam, her left pupil is large and
non-reactive. The right pupil is normal. The one type of neurological injury most consistent
with this patient's entire clinical course since her fall is:
a. a subdural
hematoma
b. an epidural hematoma
c. an occipital lobe hemorrhage
d. focal subarachnoid hemorrhage
e. a cerebellar hemorrhage
3. A 24-year-old male pedestrian, struck by an automobile, is admitted to the emergency
department 1 hour after injury. His blood pressure is 80/60 mmHg, heart rate is 140 beats per
minute, and respiratory rate is 36 breaths per minute. He is lethargic. Oxygen is delivered
via face mask, and two large-caliber IVs are initiated. Arterial blood gases are obtained. His
PaO2 is 118 mmHg (15,7 kPa), PaCO2 is 30 mmhg (4,0 kPa), and pH is 7,21. The treatment of
his acid-base disorder is best accomplished by:
a. hyperventilation
b. restoration of normal perfusion
c. initiation of low-dose dopamine
d. administration of sodium bicarbonate
e. initiation of phenylephrine infusion
4. Which of the following should be performed first in any patient whose injuries may
, include multiple closed extremity fractures?
a. A thorough assessment of four limb perfusion.
b. Maneuvers to prevent necrosis of the skin.
c. Extremity compartment syndrome release.
d. Ensuring adequate oxygenation and ventilation.
e. Evaluation for occult crush syndrome.
5. Which of the following signs is LEAST reliable for diagnosing esophageal intubation?
a. symmetrical chest wall movement
b. end-tidal CO2 presence by colorimetry
c. bilateral breath sounds
d. oxygen saturation >92%
e. ETT above carina on chest x-ray
6. Which of the following signs the necessitates a definitive airway in severe trauma patients?
a. fascial lacerations
b. repeated vomiting
c. severe maxillofacial fractures
d. sternal fracture
e. Glasgow Coma Scale score of 12
7. Twenty-seven patients are seriously injured in an aircraft crash at a local
airport. The principles of triage include:
a. establish a triage site within the internal perimeter of the crash site
b. treat only the most severely injured patients first
c. immediately transport all patients to the nearest hospital
d. treat the greatest number of patients in the shortest period of time
e. produce the greatest number of survivors based on available resources
8. Which of the following statements is correct?
a. Cerebral contusions may coalesce to form an intracerebral hematoma.
b. Epidural hematomas are usually seen in the frontal region.
c. Subdural hematomas are caused by injury to the middle meningeal artery.
d. Subdural hematomas typically have a lenticular shape on CT scan.
e. The associated brain damage is more severe in epidural hematomas.
9. An 18-ycar-old male is brought to the emergenc} department after having been shot.
He has one bullet wound just below the right clavicle and another just below the
costal margin in the right posterior axillary line. His blood pressure is110/60
mm Hg.
maysuggest aortic rupture except which one?
a. mediastinal emphysema
b. presence of a pleural cap
c. obliteration of the aortic knob
d. deviation of the trachea to the right
e. depression of the left mainstem bronchus
2. A 30-year-old woman fell down four stairs landing on concrete. Witnesses report she
was unconscious for five minutes beginning immediately after the fall. She regained
full consciousness during the ten minute transport to the hospital. Upon arrival in the
emergency department, she is awake, alert, and responsive with a Glasgow Coma Scale
score of 15. Her only complaint is a slight headache. Thirty minutes later, she becomes
unresponsive with a Glasgow Coma Scale score of 6. On the exam, her left pupil is large and
non-reactive. The right pupil is normal. The one type of neurological injury most consistent
with this patient's entire clinical course since her fall is:
a. a subdural
hematoma
b. an epidural hematoma
c. an occipital lobe hemorrhage
d. focal subarachnoid hemorrhage
e. a cerebellar hemorrhage
3. A 24-year-old male pedestrian, struck by an automobile, is admitted to the emergency
department 1 hour after injury. His blood pressure is 80/60 mmHg, heart rate is 140 beats per
minute, and respiratory rate is 36 breaths per minute. He is lethargic. Oxygen is delivered
via face mask, and two large-caliber IVs are initiated. Arterial blood gases are obtained. His
PaO2 is 118 mmHg (15,7 kPa), PaCO2 is 30 mmhg (4,0 kPa), and pH is 7,21. The treatment of
his acid-base disorder is best accomplished by:
a. hyperventilation
b. restoration of normal perfusion
c. initiation of low-dose dopamine
d. administration of sodium bicarbonate
e. initiation of phenylephrine infusion
4. Which of the following should be performed first in any patient whose injuries may
, include multiple closed extremity fractures?
a. A thorough assessment of four limb perfusion.
b. Maneuvers to prevent necrosis of the skin.
c. Extremity compartment syndrome release.
d. Ensuring adequate oxygenation and ventilation.
e. Evaluation for occult crush syndrome.
5. Which of the following signs is LEAST reliable for diagnosing esophageal intubation?
a. symmetrical chest wall movement
b. end-tidal CO2 presence by colorimetry
c. bilateral breath sounds
d. oxygen saturation >92%
e. ETT above carina on chest x-ray
6. Which of the following signs the necessitates a definitive airway in severe trauma patients?
a. fascial lacerations
b. repeated vomiting
c. severe maxillofacial fractures
d. sternal fracture
e. Glasgow Coma Scale score of 12
7. Twenty-seven patients are seriously injured in an aircraft crash at a local
airport. The principles of triage include:
a. establish a triage site within the internal perimeter of the crash site
b. treat only the most severely injured patients first
c. immediately transport all patients to the nearest hospital
d. treat the greatest number of patients in the shortest period of time
e. produce the greatest number of survivors based on available resources
8. Which of the following statements is correct?
a. Cerebral contusions may coalesce to form an intracerebral hematoma.
b. Epidural hematomas are usually seen in the frontal region.
c. Subdural hematomas are caused by injury to the middle meningeal artery.
d. Subdural hematomas typically have a lenticular shape on CT scan.
e. The associated brain damage is more severe in epidural hematomas.
9. An 18-ycar-old male is brought to the emergenc} department after having been shot.
He has one bullet wound just below the right clavicle and another just below the
costal margin in the right posterior axillary line. His blood pressure is110/60
mm Hg.
