NEW PHTLS 10TH EDITION (A NEW UPDATED VERSION)
LATEST COMPLETE ACTUAL EXAM REAL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
(CORRECT VERIFIED ANSWERS) |GUARANTEED PASS A+
(BRAND NEW!!)
Class I Hemorrhage - ANSWER: up to 15% blood loss, minimal tachicardia, no
measurable changes in BP or pulse pressure, or RR
Class II Hemorrhage - ANSWER: 15-30% Most adults are capable of compensating,
incresed RR, Tachycardia, narrowed pulse pressure,
Class III Hemorrhage - ANSWER: 30-40% no longer able to compensate for volume
loss, hypotension occurs, HR >120 BPM, RR 30-40, severe anxiety or confusion
Class IV Hemorrhage - ANSWER: more than 40% loss, severe shock, HR >140 BPM, RR
>35, confusion lethargy, decresed systolic blood pressure, typically in the range of 60
mm Hg.
Ratio for loss blood replacement - ANSWER: 3 litres of electrolyte solution
replacement for each liter of blood lost
Distributive Shock - ANSWER: uncontrolled vasodialation causes reduced resistance
causing a decrease in the diastolic blood pressure
Distributive Shock - ANSWER: Decrease in preload+decrease in cardiac output
Psychogenic Shock - ANSWER: Vasovagal - stimulation of the tenth cranial nerve
(vagus nerve) produces bradycardia. May also cause vasodilation.
Typically occurs in a very brief period.
Septic Shock - ANSWER: Cytokines released because of an infection can cause
damage to blood vessel walls and cause vasodilation
Anaphylactic Shock - ANSWER: Respiratory distress, airway obstruction and
vasodilation
Potential Blood loss from a single femoral fracture - ANSWER: 30-40%
Amount of blood loss that can happen before signs of compensatory mechanisms fail
and BP become <90 mmHq - ANSWER: Greater than 30%
Hypertension medications that may prevent compensatory tachycardia to maintain
BP - ANSWER: Beta Adrenergic blocking agents and calcium channel blockers
, Managing Volume Resuscitation
Uncontrolled hemorrhage-suspected chest, abdomen, retroperitonium - ANSWER:
Maintain a systolic bp 80-90 or MAP 60-65
Managing Volume Resuscitation
CNS injuries or TBI - ANSWER: maintaining the systolic BP (SBP) above 90 or MAP 85-
90
Managing Volume Resuscitation
Controlled Hemorrhage
large scalp or extremity controlled with a tourniquet, PT falls into class II,III,IV shock -
ANSWER: rapid bolus of 1-2 litres
Three responses of initial fluid bolus
Rapid Response - ANSWER: vital signs return indicating that PT lost less than 20%
PT is best managed at SBP between 80-90, IV fluid should be titrated
Three responses of initial fluid bolus
Transient Response - ANSWER: Vital signs improve (pulse slows, BP increases)
however PT shows deterioration. PT has typically lost 20-40% of blood volume
Three responses of initial fluid bolus
Minimal or no response - ANSWER: No change in PT after 1-2 liter Bolus
Leading cause of TBI - ANSWER: MVC
Three seperate membranes that surround the brain - ANSWER: meninges
Outer most meninges - ANSWER: Dura mater- composed of tough fibrous tissue
The inner most meninges that is directly in contact with the brain - ANSWER: Pia
Mater-
Vessels that lay on top of the Pia Mater - ANSWER: Cerebral Blood Vessels
The meninge that lays in the middle between the dura and pia matter - ANSWER:
Arachnoid membrane-loosely covers the brain and its blood vessels
MAP-Mean Arterial Pressure - ANSWER: The average pressure for the entire cardiac
cycle
MAP=Diastolic Pressure + 1/3 of the Pulse Pressure
PP- Pulse Pressure - ANSWER: The difference between the systolic and diastolic
PP= Systolic (SBP) - Distolic (DBP)
LATEST COMPLETE ACTUAL EXAM REAL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
(CORRECT VERIFIED ANSWERS) |GUARANTEED PASS A+
(BRAND NEW!!)
Class I Hemorrhage - ANSWER: up to 15% blood loss, minimal tachicardia, no
measurable changes in BP or pulse pressure, or RR
Class II Hemorrhage - ANSWER: 15-30% Most adults are capable of compensating,
incresed RR, Tachycardia, narrowed pulse pressure,
Class III Hemorrhage - ANSWER: 30-40% no longer able to compensate for volume
loss, hypotension occurs, HR >120 BPM, RR 30-40, severe anxiety or confusion
Class IV Hemorrhage - ANSWER: more than 40% loss, severe shock, HR >140 BPM, RR
>35, confusion lethargy, decresed systolic blood pressure, typically in the range of 60
mm Hg.
Ratio for loss blood replacement - ANSWER: 3 litres of electrolyte solution
replacement for each liter of blood lost
Distributive Shock - ANSWER: uncontrolled vasodialation causes reduced resistance
causing a decrease in the diastolic blood pressure
Distributive Shock - ANSWER: Decrease in preload+decrease in cardiac output
Psychogenic Shock - ANSWER: Vasovagal - stimulation of the tenth cranial nerve
(vagus nerve) produces bradycardia. May also cause vasodilation.
Typically occurs in a very brief period.
Septic Shock - ANSWER: Cytokines released because of an infection can cause
damage to blood vessel walls and cause vasodilation
Anaphylactic Shock - ANSWER: Respiratory distress, airway obstruction and
vasodilation
Potential Blood loss from a single femoral fracture - ANSWER: 30-40%
Amount of blood loss that can happen before signs of compensatory mechanisms fail
and BP become <90 mmHq - ANSWER: Greater than 30%
Hypertension medications that may prevent compensatory tachycardia to maintain
BP - ANSWER: Beta Adrenergic blocking agents and calcium channel blockers
, Managing Volume Resuscitation
Uncontrolled hemorrhage-suspected chest, abdomen, retroperitonium - ANSWER:
Maintain a systolic bp 80-90 or MAP 60-65
Managing Volume Resuscitation
CNS injuries or TBI - ANSWER: maintaining the systolic BP (SBP) above 90 or MAP 85-
90
Managing Volume Resuscitation
Controlled Hemorrhage
large scalp or extremity controlled with a tourniquet, PT falls into class II,III,IV shock -
ANSWER: rapid bolus of 1-2 litres
Three responses of initial fluid bolus
Rapid Response - ANSWER: vital signs return indicating that PT lost less than 20%
PT is best managed at SBP between 80-90, IV fluid should be titrated
Three responses of initial fluid bolus
Transient Response - ANSWER: Vital signs improve (pulse slows, BP increases)
however PT shows deterioration. PT has typically lost 20-40% of blood volume
Three responses of initial fluid bolus
Minimal or no response - ANSWER: No change in PT after 1-2 liter Bolus
Leading cause of TBI - ANSWER: MVC
Three seperate membranes that surround the brain - ANSWER: meninges
Outer most meninges - ANSWER: Dura mater- composed of tough fibrous tissue
The inner most meninges that is directly in contact with the brain - ANSWER: Pia
Mater-
Vessels that lay on top of the Pia Mater - ANSWER: Cerebral Blood Vessels
The meninge that lays in the middle between the dura and pia matter - ANSWER:
Arachnoid membrane-loosely covers the brain and its blood vessels
MAP-Mean Arterial Pressure - ANSWER: The average pressure for the entire cardiac
cycle
MAP=Diastolic Pressure + 1/3 of the Pulse Pressure
PP- Pulse Pressure - ANSWER: The difference between the systolic and diastolic
PP= Systolic (SBP) - Distolic (DBP)
