50 QUESTIONS AND ANSWERS
1. What is the correct sequence of the ATLS primary survey? a) A-B-C-D-E
b) C-A-B-D-E c) A-C-B-D-E d) B-A-C-D-E
ANSWER : a) A-B-C-D-E Explanation: Airway with cervical spine
protection, Breathing and ventilation, Circulation with hemorrhage control,
Disability (neurological status), Exposure and environmental control.
2. In a patient with severe traumatic brain injury, what is the target
PaCO2? a) 25-30 mmHg b) 35-40 mmHg c) 45-50 mmHg d) 30-35 mmHg
ANSWER : b) 35-40 mmHg Explanation: Target normal PaCO2 (35-40
mmHg). Hyperventilation causes cerebral vasoconstriction and should be
avoided except for brief periods during acute herniation.
3. What is the minimum acceptable systolic blood pressure in an adult
trauma patient? a) 80 mmHg b) 90 mmHg c) 100 mmHg d) 110 mmHg
ANSWER : b) 90 mmHg Explanation: Systolic BP < 90 mmHg defines
hypotension in adult trauma patients and requires immediate intervention.
Airway Management
4. Which of the following is a definitive airway? a) Oropharyngeal airway b)
Nasopharyngeal airway c) Endotracheal tube d) Bag-valve-mask
ANSWER : c) Endotracheal tube Explanation: A definitive airway is a cuffed
tube in the trachea with the cuff inflated, secured in place, and connected to
oxygen-enriched ventilation.
5. What is the most common indication for a surgical airway in trauma? a)
Laryngeal fracture b) Inability to intubate or ventilate c) Facial burns d)
Cervical spine injury
ANSWER : b) Inability to intubate or ventilate Explanation: The primary
indication for cricothyroidotomy is the inability to establish an airway by other
means.
, 6. In which patient should nasotracheal intubation be avoided? a) Patient
with suspected cervical spine injury b) Apneic patient c) Patient with facial
trauma d) Conscious patient
ANSWER : b) Apneic patient Explanation: Nasotracheal intubation requires
spontaneous breathing and should not be attempted in apneic patients.
Shock & Resuscitation
7. What is the initial fluid of choice for resuscitation in hemorrhagic shock?
a) 5% albumin b) Packed red blood cells c) Lactated Ringer's or normal saline
d) Fresh frozen plasma
ANSWER : c) Lactated Ringer's or normal saline Explanation: Isotonic
crystalloid solutions are the initial fluid for resuscitation, though early blood
product administration is increasingly favored in severe hemorrhagic shock.
8. What defines Class III hemorrhage? a) < 15% blood volume loss b) 15-
30% blood volume loss c) 30-40% blood volume loss d) > 40% blood volume
loss
ANSWER : c) 30-40% blood volume loss Explanation: Class III hemorrhage
involves 30-40% blood volume loss (approximately 1500-2000 mL in a 70 kg
adult).
9. What is the recommended ratio for massive transfusion protocol? a)
1:1:1 (RBC:FFP:Platelets) b) 2:1:1 (RBC:FFP:Platelets) c) 3:1:1
(RBC:FFP:Platelets) d) 4:1:1 (RBC:FFP:Platelets)
ANSWER : a) 1:1:1 (RBC:FFP:Platelets) Explanation: Balanced
resuscitation with 1:1:1 ratio reduces mortality in massive hemorrhage by
preventing dilutional coagulopathy.
10. In permissive hypotension for penetrating torso trauma, what is the
target systolic BP until hemorrhage control? a) 60-70 mmHg b) 80-90
mmHg c) 100-110 mmHg d) 120-130 mmHg
ANSWER : b) 80-90 mmHg Explanation: Permissive hypotension targets SBP
of 80-90 mmHg (or MAP 50-60) until definitive hemorrhage control to avoid
disrupting clot formation.
Thoracic Trauma
11. What is the immediate management of tension pneumothorax? a) Chest
X-ray b) Chest tube insertion c) Needle decompression d) CT scan
1. What is the correct sequence of the ATLS primary survey? a) A-B-C-D-E
b) C-A-B-D-E c) A-C-B-D-E d) B-A-C-D-E
ANSWER : a) A-B-C-D-E Explanation: Airway with cervical spine
protection, Breathing and ventilation, Circulation with hemorrhage control,
Disability (neurological status), Exposure and environmental control.
2. In a patient with severe traumatic brain injury, what is the target
PaCO2? a) 25-30 mmHg b) 35-40 mmHg c) 45-50 mmHg d) 30-35 mmHg
ANSWER : b) 35-40 mmHg Explanation: Target normal PaCO2 (35-40
mmHg). Hyperventilation causes cerebral vasoconstriction and should be
avoided except for brief periods during acute herniation.
3. What is the minimum acceptable systolic blood pressure in an adult
trauma patient? a) 80 mmHg b) 90 mmHg c) 100 mmHg d) 110 mmHg
ANSWER : b) 90 mmHg Explanation: Systolic BP < 90 mmHg defines
hypotension in adult trauma patients and requires immediate intervention.
Airway Management
4. Which of the following is a definitive airway? a) Oropharyngeal airway b)
Nasopharyngeal airway c) Endotracheal tube d) Bag-valve-mask
ANSWER : c) Endotracheal tube Explanation: A definitive airway is a cuffed
tube in the trachea with the cuff inflated, secured in place, and connected to
oxygen-enriched ventilation.
5. What is the most common indication for a surgical airway in trauma? a)
Laryngeal fracture b) Inability to intubate or ventilate c) Facial burns d)
Cervical spine injury
ANSWER : b) Inability to intubate or ventilate Explanation: The primary
indication for cricothyroidotomy is the inability to establish an airway by other
means.
, 6. In which patient should nasotracheal intubation be avoided? a) Patient
with suspected cervical spine injury b) Apneic patient c) Patient with facial
trauma d) Conscious patient
ANSWER : b) Apneic patient Explanation: Nasotracheal intubation requires
spontaneous breathing and should not be attempted in apneic patients.
Shock & Resuscitation
7. What is the initial fluid of choice for resuscitation in hemorrhagic shock?
a) 5% albumin b) Packed red blood cells c) Lactated Ringer's or normal saline
d) Fresh frozen plasma
ANSWER : c) Lactated Ringer's or normal saline Explanation: Isotonic
crystalloid solutions are the initial fluid for resuscitation, though early blood
product administration is increasingly favored in severe hemorrhagic shock.
8. What defines Class III hemorrhage? a) < 15% blood volume loss b) 15-
30% blood volume loss c) 30-40% blood volume loss d) > 40% blood volume
loss
ANSWER : c) 30-40% blood volume loss Explanation: Class III hemorrhage
involves 30-40% blood volume loss (approximately 1500-2000 mL in a 70 kg
adult).
9. What is the recommended ratio for massive transfusion protocol? a)
1:1:1 (RBC:FFP:Platelets) b) 2:1:1 (RBC:FFP:Platelets) c) 3:1:1
(RBC:FFP:Platelets) d) 4:1:1 (RBC:FFP:Platelets)
ANSWER : a) 1:1:1 (RBC:FFP:Platelets) Explanation: Balanced
resuscitation with 1:1:1 ratio reduces mortality in massive hemorrhage by
preventing dilutional coagulopathy.
10. In permissive hypotension for penetrating torso trauma, what is the
target systolic BP until hemorrhage control? a) 60-70 mmHg b) 80-90
mmHg c) 100-110 mmHg d) 120-130 mmHg
ANSWER : b) 80-90 mmHg Explanation: Permissive hypotension targets SBP
of 80-90 mmHg (or MAP 50-60) until definitive hemorrhage control to avoid
disrupting clot formation.
Thoracic Trauma
11. What is the immediate management of tension pneumothorax? a) Chest
X-ray b) Chest tube insertion c) Needle decompression d) CT scan
