Shock/Trauma 1

14 Questions | By ABSITE | Updated: Jan 22, 2013 | Attempts: 186

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1.

Complications of hypothermia include:
- A.
  
  Convulsion
- B.
  
  Tachycardia
- C.
  
  Diuresis
- D.
  
  Hypercoagulation
Correct Answer
C. Diuresis
2.

The most important prognostic factor in the Glasgow Coma Scale is:
- A.
  
  Eye opening response
- B.
  
  Verbal response
- C.
  
  Motor response
- D.
  
  Combined eye and verbal response
Correct Answer
C. Motor response
3.

In the ER following a motor crash, the patient is comatose with a GCS of 6 and remains hypotensive 60/30 after intubation and rapid infusion of 2L lactated ringers and 1 u pRBCs. The abdomen is distended and bruised. Appropriate treatment is:
- A.
  
  CT scan of the abdomen and pelvis
- B.
  
  CT of the head, abdomen and thorax
- C.
  
  DPL and 3 units of RBCs
- D.
  
  Immediate laparotomy
Correct Answer
D. Immediate laparotomy
4.

Following laparotomy for multiple intra-abdominal injuries, which required massive transfusions and IV fluids, the patient now has increased peak inspiratory pressures, decreased urinary output, hypotension, and a tense abdomen. Appropriate treatment is:
- A.
  
  Replace the endotracheal tube
- B.
  
  IV lasix
- C.
  
  Check intraabdominal pressure
- D.
  
  Increase fluids and blood product infusion
Correct Answer
C. Check intraabdominal pressure
5.

A toe dancer experiences sudden severe pain in the calf of her leg and the duplex scan and x-rays are negative. The likely diagnosis is:
- A.
  
  Achilles tendon tear
- B.
  
  Plantaris muscle/tendon rupture
- C.
  
  Fracture of the 1st metatarsal
- D.
  
  Acute thrombosis of the posterior tibial vein
Correct Answer
B. Plantaris muscle/tendon rupture
6.

Loss of waveform in a Swan-Ganz catheter indicates:
- A.
  
  Catheter location in zone 1 of the lung
- B.
  
  Trapping in the atrial trabeculae
- C.
  
  Perforation of the myocardium
- D.
  
  Persistent wedging of the catheter
Correct Answer
D. Persistent wedging of the catheter
7.

An indication for emergency thoracotomy following a GSW to the chest is:
- A.
  
  Initial chest tube drainage of 800 cc of blood
- B.
  
  Unaccounted hypotension
- C.
  
  Persistent chest tube drainage greater than 200mL/hr
- D.
  
  Clotted hemothorax
Correct Answer
C. Persistent chest tube drainage greater than 200mL/hr
8.

Adrenal insufficiency in the post-operative period is:
- A.
  
  Possible for 1 yr following corticosteroid treatment
- B.
  
  Associated with hypertension and hypokalemia
- C.
  
  Increased cardiac output and hyperglycemia
- D.
  
  Well tolerated
Correct Answer
A. Possible for 1 yr following corticosteroid treatment
9.

Initial management of an obtunded MVA patient who is intubated and ventilated and is hypotensive with a distended abdomen and positive DPL is:
- A.
  
  Transfusion of blood and crystalloid solution
- B.
  
  CT scan of head and chest
- C.
  
  Immediate laparotomy
- D.
  
  Vasopressors to raise BP and CPP
Correct Answer
C. Immediate laparotomy
10.

Management of a patient with an open book (3cm) pelvic fracture with hypotension who is initially responsive to a transfusion and then becomes hypotensive again is:
- A.
  
  Application of anterior external fixation
- B.
  
  Application of pneumatic anti-shock garment
- C.
  
  Angiographic embolization
- D.
  
  Laparotomy with pelvic packing
Correct Answer
A. Application of anterior external fixation
11.

Signs of cardiac tamponade with trans-thoracic echocardiography are:
- A.
  
  Decrease of right ventricular volume with inspiration
- B.
  
  Collapse of the IVC with inspiration
- C.
  
  Increase of left ventricular volume with inspiration
- D.
  
  Collapse of the right and left atria
Correct Answer
D. Collapse of the right and left atria
12.

The treatment of a femur fracture in a patient with a pulmonary contusion causing pulmonary insufficiency is best managed by:
- A.
  
  Balanced traction
- B.
  
  Delayed open internal fixation for 10 days
- C.
  
  Immediate intra-medullary fixation
- D.
  
  Early (within 24 hrs) open fixation with plate and screws
Correct Answer
C. Immediate intra-medullary fixation
13.

Diagnosis of an anterior cruciate ligament tear is determined by:
- A.
  
  Reverse drawer test
- B.
  
  Pivotal shift maneuver
- C.
  
  A negative lachman test
- D.
  
  Negative drawer test
Correct Answer
B. Pivotal shift maneuver
14.

Findings associated with a posterior hip dislocation include:
- A.
  
  Abduction of the thigh
- B.
  
  Acetabular or femoral neck fractures
- C.
  
  Spontaneous reduction is less common
- D.
  
  Injury to the femoral artery is frequent
Correct Answer
B. Acetabular or femoral neck fractures

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Current Version
Jan 22, 2013

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Jan 09, 2011

Quiz Created by
ABSITE

Shock/Trauma 1

Complications of hypothermia include:

The most important prognostic factor in the Glasgow Coma Scale is:

In the ER following a motor crash, the patient is comatose with a GCS of 6 and remains hypotensive 60/30 after intubation and rapid infusion of 2L lactated ringers and 1 u pRBCs. The abdomen is distended and bruised. Appropriate treatment is:

Following laparotomy for multiple intra-abdominal injuries, which required massive transfusions and IV fluids, the patient now has increased peak inspiratory pressures, decreased urinary output, hypotension, and a tense abdomen. Appropriate treatment is:

A toe dancer experiences sudden severe pain in the calf of her leg and the duplex scan and x-rays are negative. The likely diagnosis is:

Loss of waveform in a Swan-Ganz catheter indicates:

An indication for emergency thoracotomy following a GSW to the chest is:

Adrenal insufficiency in the post-operative period is:

Initial management of an obtunded MVA patient who is intubated and ventilated and is hypotensive with a distended abdomen and positive DPL is:

Management of a patient with an open book (3cm) pelvic fracture with hypotension who is initially responsive to a transfusion and then becomes hypotensive again is:

Signs of cardiac tamponade with trans-thoracic echocardiography are:

The treatment of a femur fracture in a patient with a pulmonary contusion causing pulmonary insufficiency is best managed by:

Diagnosis of an anterior cruciate ligament tear is determined by:

Findings associated with a posterior hip dislocation include: