ATLS
10. A 22 year - old man is brought by ambulance to the Emergency Department with a
severe traumatic brain injury. On examination he is hypertensive. Which of the following
statements is CORRECT?:
Should be treated to reduce intracranial pressure.
May indicate imminent herniation from critically high intracranial pressure.
Indicates preexisting hypertension.
Mandates prompt administration of mannitol.
Should prompt burr hole drainage of potential subdural hematomas. - ANS
Should be treated to reduce intracranial pressure.
55 + 28. Regarding supraglottic airway devices, which of the following statements is
CORRECT?:
Are equivalent to endotracheal intubation.
Require neck extension for proper placement.
Are preferable to endotracheal intubation in a patient who cannot lie flat.
Are of value as part of a difficult or failed intubation plan.
Provide one form of definitive airway. - ANS Are of value as part of a difficult or
failed intubation plan.
9. Which is the most important consequence of inadequate organ perfusion?:
Multiple organ failure.
Decreased base deficit.
Acute glomerulonephritis.
Increased cellular adenosine triphosphate (ATP) production.
Vasodilation. - ANS Multiple organ failure.
, A 15 year - old boy is brought to the ED following a motorcycle crash. Initial examination
reveals normal vital signs. There is a large bruise over his epigastrium that extends to
the left flank. He has no other apparent injuries. A CT scan of the abdomen
demonstrates a ruptured spleen surrounded by a large hematoma and fluid in the
pelvis. The next step in this patient's management is:
Splenic artery embolization.
Pneumococcal vaccine.
Transfer to a pediatrician.
Urgent laparotomy.
Surgical consultation. - ANS Surgical consultation.
A 19 year - old girl with learning disabilities and severe cervical kyphoscoliosis is
brought to the Emergency Department with a GCS of 6. Intubation is performed but you
are not completely sure that you are in the airway tract. Which of the following signs is
least reliable for diagnosing the esophageal intubation?:
Symmetrical chest wall movement.
End - tidal CO2.
Bilateral breath sounds.
Oxygen saturation.
Chest x-ray demonstrating endotracheal tube tip positioned above the carina. - ANS
Symmetrical chest wall movement.
A 22 year - old man is stabbed in the abdomen. He is brought to the Emergency
Department where his blood pressure shows 85/60 mm Hg with heart rate of 130,
respiratory rate of 25 bpm, and Glasgow Coma Scale score is 14. Neck veins are flat,
and chest examination is clear with bilateral breath sounds. Optimal resuscitation
should include:
Transfusion of fresh frozen plasma and platelets.
500 mL of hypertonic saline and transfusion of packed red blood cells.
Resuscitation with crystalloid and packed red blood cells until base excess is normal.
10. A 22 year - old man is brought by ambulance to the Emergency Department with a
severe traumatic brain injury. On examination he is hypertensive. Which of the following
statements is CORRECT?:
Should be treated to reduce intracranial pressure.
May indicate imminent herniation from critically high intracranial pressure.
Indicates preexisting hypertension.
Mandates prompt administration of mannitol.
Should prompt burr hole drainage of potential subdural hematomas. - ANS
Should be treated to reduce intracranial pressure.
55 + 28. Regarding supraglottic airway devices, which of the following statements is
CORRECT?:
Are equivalent to endotracheal intubation.
Require neck extension for proper placement.
Are preferable to endotracheal intubation in a patient who cannot lie flat.
Are of value as part of a difficult or failed intubation plan.
Provide one form of definitive airway. - ANS Are of value as part of a difficult or
failed intubation plan.
9. Which is the most important consequence of inadequate organ perfusion?:
Multiple organ failure.
Decreased base deficit.
Acute glomerulonephritis.
Increased cellular adenosine triphosphate (ATP) production.
Vasodilation. - ANS Multiple organ failure.
, A 15 year - old boy is brought to the ED following a motorcycle crash. Initial examination
reveals normal vital signs. There is a large bruise over his epigastrium that extends to
the left flank. He has no other apparent injuries. A CT scan of the abdomen
demonstrates a ruptured spleen surrounded by a large hematoma and fluid in the
pelvis. The next step in this patient's management is:
Splenic artery embolization.
Pneumococcal vaccine.
Transfer to a pediatrician.
Urgent laparotomy.
Surgical consultation. - ANS Surgical consultation.
A 19 year - old girl with learning disabilities and severe cervical kyphoscoliosis is
brought to the Emergency Department with a GCS of 6. Intubation is performed but you
are not completely sure that you are in the airway tract. Which of the following signs is
least reliable for diagnosing the esophageal intubation?:
Symmetrical chest wall movement.
End - tidal CO2.
Bilateral breath sounds.
Oxygen saturation.
Chest x-ray demonstrating endotracheal tube tip positioned above the carina. - ANS
Symmetrical chest wall movement.
A 22 year - old man is stabbed in the abdomen. He is brought to the Emergency
Department where his blood pressure shows 85/60 mm Hg with heart rate of 130,
respiratory rate of 25 bpm, and Glasgow Coma Scale score is 14. Neck veins are flat,
and chest examination is clear with bilateral breath sounds. Optimal resuscitation
should include:
Transfusion of fresh frozen plasma and platelets.
500 mL of hypertonic saline and transfusion of packed red blood cells.
Resuscitation with crystalloid and packed red blood cells until base excess is normal.
