ATLS QUESTIONS TEST EXAM |LATEST
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An electrician is eletrocuted by a downed power line after a thunderstorm. He apparently made
contact with the wire at the level of the right mid thigh. In the ED, his vital signs are normal and
no dysrythmia is noted on ECG. On examination, there is an exit wound on the bottom of the
right foot. His urine is positive for blood by dipstick but not RBCs are seen microscopically.
Initial management should include:
A. Immediate angiography
B. Aggressive fluid infusion
C. Intravenous pyelography
D. Debridement of necrotic muscle
E. Admission to the ICU for observation
- ANSWERS-B. Aggressive fluid infusion - suspected rhabdomyolyse
A young woman sustains a severe head injury as the result of a motor vehicular crash. In the ED,
her GCS is 6. Her blood pressure is 140/90 mmHg and her heart rate 80 beats per minute. She is
intubated and is being mechanically ventilated. Her pupils are 3mm in size and equally reactive
to light. There is no other apparent injury. The most important principle to follow in early
management of her head injury is to:
A. Administer an osmotic diuretic
B. Prevent secondary brain injury
C. Agressively treat systemic hypertension
D. Reduce meatbolic requirements of the brain
E. Distinguish between intracranial hematoma and cerebral edema.
- ANSWERS-B. Prevent secondary brain injury
,To establish a diagnosis of shock,
A. Systolic blood pressure must be below 90mmHg
B. The presence of a closed head injury should be excluded
C. Acidosis should be present by arterial blood gas analysis
D. The patient must fail to respond to intravenous fluid infusion
E. Clinical evidence of inadequate organ perfusion must be present
. - ANSWERS-E. Clinical evidence of inadequate organ perfusion must be present.
A 32-year-old is brought to the hospital unconscious with severe facial injuries and noisy
respirations after an automobile collision. In the ED, he has no apparent injury to the anterior
aspect of his neck. He suddenly becomes apneic, and attempted ventilation with a face mask is
unsuccessful. Examination of his mouth reveals a large hematoma of the pharynx with loss of
normal anatomic landmarks. Initial management of his airways should be consist of:
A. Inserting an oropharyngeal airway
B. Inserting a nasopharyngeal airway
C. Performing a surgical cricothyroidotomy
D. Performing fiberoptic-guided nasotracheal intubation
E. Performin orotracheal intubation after obtaining a lateral c-spine x-ray
- ANSWERS-A. Inserting an oropharyngeal airway
A 25-year-old woman is brought to the ED after a motor vehicle crash. She was initially lucid at
the scene and then developed a dilated pupil and contralateral extremity weakness. In the ED,
she is unconscious and has a GCS score of 6. The initial management step for this patient should
be to:
A. Obtain a CT-scan of the head
B. Administer decadron 20mg IV
C. Perform endotracheal intubation
D. Administer mannitol 1g/kg IV
, E. Perform an emergency bone flap craniotomy on the side of the dilated pupil.
- ANSWERS-C. Perform endotracheal intubation
A contraindication to nasogastric intubation is the presence of a:
A. Gastric perforation
B. Diaphragmatic rupture
C. Open depressed skull fracture
D. Fracture of the cervical spine
E. Fracture of the cribiform plate
- ANSWERS-E. Fracture of the cribiform plate
An 8-year-old girl is an unrestrained passenger in a vehicle struck from behind. In the ED, her
blood pressure is 80/60mmHg, heart rate is 80 beats per minute, and respiratory rate is 16
breaths per minute. Her GCS score is 14. She complains that her legs feel "funny and wont
move right". However, her spine x-rays do not show a fracture or dislocation. A spinal cord
injury in this child:
A. Is most likely a central cord syndrome
B. Must be diagnosed by magnetic resonance imaging
C. Can be excluded by obtaining a CT-scan of the entire spine
D. May exist in the abscence of objective findings on x-ray studies
E. Is unlikely because of the incomplete calcification of the vertebral bodies.
- ANSWERS-D. May exist in the abscence of objective findings on x-ray studies
Immediate chest tube insertion is indicated for which of the following conditions?
A. Pneumothorax
B. Pneumomediastinum
C. Massive hemothorax
D. Diaphragmatic rupture
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