بسم اهلل الرحمن الرحيم
First group ATLS MCQs 1- triage concept : save more lives with available resources 2- a patient with gunshot , BP 70/0 , Chest tube drained 120 ml , chest sounds normal. next step? - Laparatomy 3- persistent pneumothorax after placing chest tube. Diagnosis? - Tracheobronchial injury 4- which of the following is not part of the initial assessment? - determining incomplete,or complete neurological deficit 5- echomosys in prenium , blood in meatus ,what will you do? - retrograde urethrogram 6- Class II shock: - normal BP 7- patient with minimal trauma to chest and tenderness, ABCDE are good, how to manage? - pain medication 8- old patient on B-blocker and Coumadin (warfarin), decreased BP, normal pulse, which of the following is true? - excessive fluids cause cardiopulmonary failure. 9- indication for intubation? - maxilofacial injury 10- moderate head injury- GCS 11, what to do? - CT scan + repeat GCS assessment 11- Neurogenic shock except: neurologic deficit 12- Neurogenic shock management: vassopressor 13- initial step in multiple injured pt: ask the patient's name 14- pt. with blunt trauma to abdomen.. Decreased BP, no external bleeding: FAST 15- DPL: most sensetive 16- unsucceful endotracheal intubation: surgical cricothyroidectomy 17- anatomy: choroid plexus produce CSF in the lateral and third ventricle.. 18- failed intubation: bogie 19- unconscious baby then awake then deteriorate: epidural 20- pt fell and can't move lower limb with sensory problem: spinal shock 21- laparotomy indication: CT with retroperitoneal air 22- circumfrential burn: escharotomy 23-Pediatric: flexible mediastinum 24- sacral sparing: good prognosis 25- most common cause of acid base problem in pediatrics: ventilation 26- 80 kg male with 50% burn and received 1 L NS came after 3 hour.. What is the fluid per hour in the next 5 hours? 1400 ml/hr 27- X-ray of ruptured aorta except: air in mediastinum
28- indication to anti-Rh in pregnant women except: gunshot wound to the foot 29- pregnant lady with PV bleeding, initial assessment Airway.. 30- difficulty in respiration, loss of sensation in the foot? - possible cervical injury
! ! Second group ATLS MCQs
1. Which of the following is addressed in the secondary survey? Answer: Forearm fracture 2. A young male fallen from height with obvious flail chest. ABG shows pH of 7.47. what is the cause of this abnormality? Answer: pulmonary contusion 3. Cushing's triad which occurs in cases of increased intracranial pressure? Answer: Bradycardia with irregular respirations and isolated increase in SYSTOLIC BLOOD PRESSURE. 4. Trauma in pregnant women, clear fluid leakage from vagina is an indication for hospitalization. 5. Blood at the external meatus ! do RUG 6. Scenario of pelvic fracture, which statement is correct? Answer: vertical shear force with posterior ligaments disruption. 7. 12 year old boy sustained blunt abdominal trauma while playing football. FAST scan is positive. He is hemodynamically stable. What to do next? Answer: CT abdomen 8. Old patient, had multiple rib fractures, splinting of the right chest, what to do? Answer: give analgesic. 9. Memorize indications for burn transfer ( eg > mixed partial and full thickness burn >10% of total BSA ! transfer) 10. In comparison with young adults, elderly patients exhibit which of the following regarding brain injuries? A- increased cerebral blood flow. B- less stretching of bridging veins C- less subdural hematomas D- less brain contusions E- les mobility with angular acceleration and deceleration. Answer is D, less brain contusions than younger adults. 11. Which of the following will be missed by DPL? Answer: subcapsular hematoma of the spleen (because it is a retroperitoneal organ) 12. Which of the following tests will evaluate the retroperitonium? Answer: CT 13. Patient tried to commit suicide with a rope (hyperextension of the neck), when he presented to ER he had hoarsness of voice and crepitation in the neck, what to do? Aneedle cricothyroidotomy B- surgical tracheostomy in OR C- direct laryngoscopy and intubation. Answer: ???? 14. Burn victim with signs of inhalation injury (carboneacous material, singed eyebrows) ! Intubate.
15. Burn victim, has circumferential burn, core temperature is 34 C. what next? Aescharatomy B- rewarm C- oxygen mask (I think the answer is C oxygen mask because you should follow the ABCD priorities) 16. Which of the followings is NORMAL in pregnancy? A-increased residual lung volume Bdecreased plasma volume C- decreased total RBC mass D- widened symphysis pubis. Answer is D 17. Trauma patient was hypotensive then you gave him 1 L of crystalloid and now he is alert and talking. Which of the following statements is correct? Answer: He has good cerebral blood flow 18. Which of the followings is a contraindication for nasal intubation? A- depressed skull fracture B- Le Fort III fractures. Answer is B (Le Fort III fractures causes cribriform plate fracture) 19. Which of the followings will benefit from oropharyngeal airway? A- posterior displacement of tongue B- laryngeal edema. Answer is A 20. Patient came with severe head injury GCS is 6 and has poor anal sphincter tone and diagrammatic breathing. His hands are flexed across the chest. What is the cause of his injury? A-isolated head injury. B-lumbosacral verterbral injury. C- Cervical vertebral injury. Answer is C 21. Patient with sever substernal pain. CXR shows widened mediastenum? do ECG 22. Question about spinal board? A-Remove after completing assessment B- it leads to decubetus ulcers .. answer: ???? 23. CSF is between? Arachinoid and pia matter. 24. Question about transfer? Transfer after stabilizing the patient. 25. Scenario with scalp laceration .. the priority was to stop the bleeding with direct pressure. The other choices are all after the circulation. 26. Patient with head injury and systemic hypotension, what is the most probable cause of his hypotension? A- bleeding in the brain B- systemic hypovolemia. Answer is B 27. Dorsal column? Carries proprioception from the same side of the body. 28. Elderly fallen from horse.. low blood pressure but normal heart rate…answer: current medications might be involved. 29. Neurogenic shock.. answer: unlikely if injury below the level of T6. 30. Which of the followings will NOT have an effect of the clinical presentation of hemorrhagic shock? A- gender B- age extremes C- delay in transfer Answer:??? 31. Patient with stab wound to the upper abdomen. Which test to do? A- abdominal X ray B- FAST C- barium enema D- upper GI endoscopy. Answer: B 32. Question about burn and fall from height. Answer: examine the pelvis and the long bones for fractures.