Which one of the following statements is false concerning Rh isoimmunization in pregnant
trauma patients?
A. It occurs in blunt or penetrating abdominal trauma.
B. It is produced by minor degrees of fetomaternal hemorrhage.
C. Rh immunoglobulin therapy should be administered to pregnant females who have sustained
agunshot wound to the leg.
D. This is not a problem in traumatized, Rh-positive pregnant patients.
E. Initiation of Rh immunoglobulin therapy does not require proof of fetomaternal hemorrhage.
An 18-year-old motorcyclist sustains massive facial injuries in a head-on crash with a pick-up
truck. He is brought to the emergency department completely immobilized on a long spine board
and wearing a cervical collar. His blood pressure is 150/88 mmHg, heart rate is 88 beats per minute
and regular, and respiratory rate is 26 breaths per minute. His respirations are labored and
sonorous. His Glasgow Coma Scale score is 7. Attempts at orotracheal intubation with manual inline
stabilization of the c-spine are unsuccessful due to bleeding and distorted anatomy. The patient
becomes apneic. The best procedure for airway management in this situation is:
A. nasotrachealintubation
B. emercency tracheostomy
C. surgical cricothyroidotomy
d. placement of an oropharyngeal airway
e. placement of a nasopharyngeal airway
A 26-year-old male is brought to the hospital after sustaining partial and full-thickness burns
involving 60% of his body surface area. His right arm and hand are severely burned. There are
obvious full-thickness burns of the entire right hand and a circumferential burn of the right arm.
Pulses are absent at the right wrist and are not detected by Doppler examination. The first step
management of the right upper extremity should be:
A. fasciotomy
, B. angiography
C. scharotomy
d. heparinization
e. tangential excision
All of the following signs on the chest x-ray of a patient who sustained a blunt injury may
suggest 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
A 31-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
A 25-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 viaface 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
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.
trauma patients?
A. It occurs in blunt or penetrating abdominal trauma.
B. It is produced by minor degrees of fetomaternal hemorrhage.
C. Rh immunoglobulin therapy should be administered to pregnant females who have sustained
agunshot wound to the leg.
D. This is not a problem in traumatized, Rh-positive pregnant patients.
E. Initiation of Rh immunoglobulin therapy does not require proof of fetomaternal hemorrhage.
An 18-year-old motorcyclist sustains massive facial injuries in a head-on crash with a pick-up
truck. He is brought to the emergency department completely immobilized on a long spine board
and wearing a cervical collar. His blood pressure is 150/88 mmHg, heart rate is 88 beats per minute
and regular, and respiratory rate is 26 breaths per minute. His respirations are labored and
sonorous. His Glasgow Coma Scale score is 7. Attempts at orotracheal intubation with manual inline
stabilization of the c-spine are unsuccessful due to bleeding and distorted anatomy. The patient
becomes apneic. The best procedure for airway management in this situation is:
A. nasotrachealintubation
B. emercency tracheostomy
C. surgical cricothyroidotomy
d. placement of an oropharyngeal airway
e. placement of a nasopharyngeal airway
A 26-year-old male is brought to the hospital after sustaining partial and full-thickness burns
involving 60% of his body surface area. His right arm and hand are severely burned. There are
obvious full-thickness burns of the entire right hand and a circumferential burn of the right arm.
Pulses are absent at the right wrist and are not detected by Doppler examination. The first step
management of the right upper extremity should be:
A. fasciotomy
, B. angiography
C. scharotomy
d. heparinization
e. tangential excision
All of the following signs on the chest x-ray of a patient who sustained a blunt injury may
suggest 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
A 31-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
A 25-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 viaface 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
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.
