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ATLS EXAM BEST STUDYING MATERIAL WITH VERIFIED ANSWERS LATEST VERSION UPDATE WITH 100+ QUESTIONS
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ATLS EXAM BEST STUDYING MATERIAL WITH VERIFIED ANSWERS LATEST VERSION UPDATE WITH 100+ QUESTIONS
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ATLS EXAM BEST STUDYING MATERIALWITH VERIFIED ANSWERS LATEST
VERSION UPDATE 2024-2025 WITH 100+
QUESTIONS
muffled heart sounds, hypotension, and distended necks veins may not always be present in
cardiac tamponade. Kussmaul's sign (rise in venous pressure with inspiration when breathing
spontaneously) is a true paradoxical venous pressure abnormality that is associated with
tamponade
- CORRECT ANS-The presence of hyperresonance on percussion indicated tension
pneumothorax whereas presence of bilateral breath sounds is cardiac tamponade. FAST can
identify cardiac tamponade. if FAST is unavailable, use echo or pericardial window. definitive
treatment is surgery so thoracotomy or sternotomy.
potentially life threatening injuries that should be identified on secondary survey
- CORRECT ANS-simple pneumothorax, hemothorax, flail chest, pulmonary contusion, blunt
cardiac injury, traumatic aortic disruption, traumatic diaphragmatic injury, esophageal rupture
pulmonary contusion can occur with rib fractures and flail chest (two or more adjacent ribs
fractured in two or more places)
. - CORRECT ANS-initial treatment includes humidified oxygen, adequate ventilation, and
cautious fluid resuscitation. definitive treatment includes pain control, adequate oxygenation
Blunt cardiac injury can present with hypotension, dysrhythmias, EKG changes, premature
ventricular contractions, unexplained sinus tachycardia, AFib, bundle branch block, elevated
central venous pressure without any obvious cause may indicate right ventricular dysfunction
secondary to contusion.
- CORRECT ANS-cardiac troponins can be diagnostic in an MI but have little role in diagnosing
blunt cardiac injury. patients with a blunt injury to the heart diagnosed by conduction
abnormalities are at increased risk for sudden dysrhythmias and need to be monitored for 24
hours.
,Traumatic aortic disruption- most survive if they have an incomplete laceration near the
ligmentum arteriosum. commonly caused by vehicle collision or fall from a great height. have a
high index of suspicion if history has decelerating force.
- CORRECT ANS-Look for widened mediastinum on chest xray, obliteration of the aortic knob,
deviation of the trachea to the right, depression of the L mainstem bronchus, elevation of R
mainstem bronchus, deviation of the esophagus to the right, left hemothorax, presence of the
pleural or apical cap, fractures of the first or second rib or scapula, widened paraspinal
interface, widened paratracheal stripe.
In a traumatic aortic rupture, heart rate and blood pressure control can decrease the likelihood
of rupture.
- CORRECT ANS-definitive treatment is surgery.
Diaphragmatic injury-displaced bowel, stomach, and nasogastric tube on left side.
- CORRECT ANS-The appearance of peritoneal lavage fluid in the chest tube also confirms
diagnosis
esophageal injury- clinical picture is a patient with a left pneumothorax or hemothorax without
a rib fracture who has received a severe blow to the lower sternum or epigastrum and is in pain
or shock out of proportion to the apparent injury
- CORRECT ANS-presence of mediastinal air also suggests diagnosis and definitive treatment is
direct repair of the injury.
injuries to the retroperitoneal structures are difficult to recognize because they occur deep
within the abdomen and may not initially present with signs or symptoms of peritonitis. -
CORRECT ANS-the retroperitoneal space is NOT sampled by DPL or FAST
physical exam findings suggestive of a pelvic fracture include:
- CORRECT ANS-ruptured urethra, scrotal hematoma or blood at the urethral meatus,
discrepancy in limb length and rotational deformity of a leg w/o obvious fracture. use pelvic
binder that is centered at the greater trochanters rather than over the iliac crests.
, signs of urethral injury include:
- CORRECT ANS-blood at the uretheral meatus, ecchymosis or hematoma of the scrotum and
perineum. Palpation of the prostate gland is NOT a reliable sign of urethral injury.
a retrograde urethorgram is mandatory when the patient is unable to void, requires a pelvic
binder, or has blood at the meatus, scrotal hematoma, or perineal ecchymosis. confirm an
intact urethra before inserting a urinary catheter.
DPL: Aspiration of gastrointestinal contents, vegetable fibers, or bile through the lavage
mandate laparotomy. Aspiration of 10cc or more of blood in hemodynamically abnormal
patients requires laporotomy.
- CORRECT ANS-performed rapidly, invasive procedure
sensitive for detecting intraperitoneal hemorrhage
low specificity
requires gastric and urinary decompression
not repeatable
a positive DPL is an indication for laparotomy
contraindications include previous abdominal operations, morbid obesity, advanced cirrhosis,
pre-existing coagulopathy.
FAST
- CORRECT ANS-noninvas and can be done rapidly
repeatable
does not assess retroperitoneal structures.
obesity can degrade images obtained by FAST
indications for a laparotomy:
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