TCRN COMPLETE REVIEW 2024 EXAM WITH
CORRECTLY ANSWERED QUESTION!!!
Which kidney is most commonly injured in trauma? - ANSWER- Right
it sits lower and is not protected by the rib cage.
Straddle injury - ANSWER- an injury to the pelvis and the posterior urethra between the
genitals and anus that results when a patient forcefully straddles a fixed object.
Intravenous pyelogram (IVP) - ANSWER- x-ray of kidney following injection of dye into
vein to visualize renal pelvis as kidney filters dye out of bloodstream and puts it into
urine.
What is the nonoperative management of hematuria in a stable patient? - ANSWER-
Bed rest for 24-48 hours
What blood component does not require ABO typing? Why? - 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? - ANSWER- Zygomatic bone check bone
In DIC is fibrinogen increased or decreased? - ANSWER- It will be decreased cause they
are being used up in the initial clot formation.
What are the 3 types of distributive shock? - ANSWER- Anaphlaxis, septic and
Neurogenic
What are the 4 typesof shock? - ANSWER- Cardiogenic, Hypovolemic, Obstructive,
Distributive
,Who does obstructive shock affect more? - ANSWER- Pregnant woman from uterus
pressure on thoracic cavity
What is the purpose of glucose stores in the liver - 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? -
ANSWER- the WBS/Neutrophils are paralyzed about 120 mg'dl
What is automaticity of the heart? - ANSWER- It the speed of the electricity in the heart
What does an increase of automaticity tend to cause? - ANSWER- Arrthymias
What do inflammatory mediators cause - ANSWER- systemic vasodilation to flood the
area with RBS,WBS and O2
What is the pulse pressure ? - ANSWER- Systolic minus diastolic
What is the systolic blood pressure? - ANSWER- The squeeze of teh ventricles
What is the diastolic blood pressure? - ANSWER- the peripheal blood pressure or
vascular resistance
What is sterlings law? - ANSWER- The further soomething streches the stronger the
contraction
How do you calculate MAP? - ANSWER- diastolic x2 plus (+) systolic divided by 3
Why would not place an IO in a certain bone? - ANSWER- Fracture in bone or previous
failed attempts in same bone
What is the calculation for pediataric fluid bolus ? - ANSWER- 20 cc/kg
,What do colloids do? - 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? - ANSWER- Fluids do not
carry oxygen but RBCs do.
What are the other lab levels for DIC? - 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? - 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? - ANSWER- 1 g/l Hgb and 3% Hct
What is th unit size for an order of PRBCs? - ANSWER- 250 cc
One unit of platelets increase serum level by how much? - ANSWER- 5-10K you will be
giving multiple units
Where are most clotting factors located in blood? - ANSWER- Fresh Frozen Plasma
Each unit of FFP increases serum by hw much? - ANSWER- 7%
What are cryoprecipitates? - ANSWER- Respun FFP - WBC make be leukoreduced
What is the universal blood donor? - ANSWER- O - use O - in females or O+ in males
What s the universsal donor for fresh frozen plasma? - ANSWER- AB blood no
antibodies
, In large blood transfusions what electrolytes do you watch closely? - 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? - ANSWER- Allowing the BP to be lower as to not blow
a formed clot
What type of injury is permissive hypotension best for? - ANSWER- penetration not so
much fro blunt, or head injury. elderly or ped
What are some end points of resuscitation? - 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? - 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? -
ANSWER- Risk of infection
What are the parametrs for base defieciet? - ANSWER- 4 wide spread hypoperfusin
6 severe injury
What is neurogenic shock? - ANSWER- failure of the sympathetic system - involves
widespread vasodilation
Where does injury tnd to occur in neurogenic shock? - ANSWER- T4-T6 and above
What are symptoms of neurgenic shock? - ANSWER- Bradycardia, decreased
contracility, decreased automaticity, decreased respiratory, dry skin, cholinergic reaction
CORRECTLY ANSWERED QUESTION!!!
Which kidney is most commonly injured in trauma? - ANSWER- Right
it sits lower and is not protected by the rib cage.
Straddle injury - ANSWER- an injury to the pelvis and the posterior urethra between the
genitals and anus that results when a patient forcefully straddles a fixed object.
Intravenous pyelogram (IVP) - ANSWER- x-ray of kidney following injection of dye into
vein to visualize renal pelvis as kidney filters dye out of bloodstream and puts it into
urine.
What is the nonoperative management of hematuria in a stable patient? - ANSWER-
Bed rest for 24-48 hours
What blood component does not require ABO typing? Why? - 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? - ANSWER- Zygomatic bone check bone
In DIC is fibrinogen increased or decreased? - ANSWER- It will be decreased cause they
are being used up in the initial clot formation.
What are the 3 types of distributive shock? - ANSWER- Anaphlaxis, septic and
Neurogenic
What are the 4 typesof shock? - ANSWER- Cardiogenic, Hypovolemic, Obstructive,
Distributive
,Who does obstructive shock affect more? - ANSWER- Pregnant woman from uterus
pressure on thoracic cavity
What is the purpose of glucose stores in the liver - 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? -
ANSWER- the WBS/Neutrophils are paralyzed about 120 mg'dl
What is automaticity of the heart? - ANSWER- It the speed of the electricity in the heart
What does an increase of automaticity tend to cause? - ANSWER- Arrthymias
What do inflammatory mediators cause - ANSWER- systemic vasodilation to flood the
area with RBS,WBS and O2
What is the pulse pressure ? - ANSWER- Systolic minus diastolic
What is the systolic blood pressure? - ANSWER- The squeeze of teh ventricles
What is the diastolic blood pressure? - ANSWER- the peripheal blood pressure or
vascular resistance
What is sterlings law? - ANSWER- The further soomething streches the stronger the
contraction
How do you calculate MAP? - ANSWER- diastolic x2 plus (+) systolic divided by 3
Why would not place an IO in a certain bone? - ANSWER- Fracture in bone or previous
failed attempts in same bone
What is the calculation for pediataric fluid bolus ? - ANSWER- 20 cc/kg
,What do colloids do? - 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? - ANSWER- Fluids do not
carry oxygen but RBCs do.
What are the other lab levels for DIC? - 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? - 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? - ANSWER- 1 g/l Hgb and 3% Hct
What is th unit size for an order of PRBCs? - ANSWER- 250 cc
One unit of platelets increase serum level by how much? - ANSWER- 5-10K you will be
giving multiple units
Where are most clotting factors located in blood? - ANSWER- Fresh Frozen Plasma
Each unit of FFP increases serum by hw much? - ANSWER- 7%
What are cryoprecipitates? - ANSWER- Respun FFP - WBC make be leukoreduced
What is the universal blood donor? - ANSWER- O - use O - in females or O+ in males
What s the universsal donor for fresh frozen plasma? - ANSWER- AB blood no
antibodies
, In large blood transfusions what electrolytes do you watch closely? - 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? - ANSWER- Allowing the BP to be lower as to not blow
a formed clot
What type of injury is permissive hypotension best for? - ANSWER- penetration not so
much fro blunt, or head injury. elderly or ped
What are some end points of resuscitation? - 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? - 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? -
ANSWER- Risk of infection
What are the parametrs for base defieciet? - ANSWER- 4 wide spread hypoperfusin
6 severe injury
What is neurogenic shock? - ANSWER- failure of the sympathetic system - involves
widespread vasodilation
Where does injury tnd to occur in neurogenic shock? - ANSWER- T4-T6 and above
What are symptoms of neurgenic shock? - ANSWER- Bradycardia, decreased
contracility, decreased automaticity, decreased respiratory, dry skin, cholinergic reaction
