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2024 ATLS EXAM WITH CORRECT ANSWERS
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2024 ATLS EXAM WITH CORRECT ANSWERS
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2024 ATLS EXAM WITH CORRECTANSWERS
TBI treatment - CORRECT-ANSWERSIV fluids & hypertonic saline (do not give
hypotonic fluids or glucose containing fluids because this can harm the
injured brain)
Avoid hyponatremia
reversal of anticoagulants
Hyperventilation to keep PaCO2 at 35-temporizing measure
Mannitol-do not give to patients with hypotension
reversal agents: - CORRECT-ANSWERSaspirin/plavix: platelets
warfarin: FFP, vitamin K, Prothrombin Complex
Heparin or LMWH: Protamine Sulfate
Direct thrombin inhibitors: Idarucizumab
Rivaroxaban: N/A
Neurogenic shock - CORRECT-ANSWERSloss of vasomotor tone and
sympathetic innervation to the heart. Injury T6 and above can cause
impairment of the sympathetic pathways. We get hypotension and
bradycardia.
Neurogenic shock is not reversed with fluid resuscitation alone. Vasopressors
may be required.
spinal shock refers to the loss of muscle tone (flaccid) and reflexes
immediately after injury
Central cord syndrome - CORRECT-ANSWERSloss of function in upper
extremities > lower extremities occurring after a hyperextension injury,
forward fall resulting in facial impact.
Anterior Cord Syndrome - CORRECT-ANSWERSinjury to the motor and
sensory pathways in the anterior part of cord. paraplegia and bilateral loss of
pain and temp. However, position, vibration, and deep pressure sense are
preserved (sensations from dorsal columns). commonly due to cord ischemia
,Brown-Sequard Syndrome - CORRECT-ANSWERSresults from hemisection of
the spinal cord. Ipsilateral motor loss and loss of position sense and
contralateral loss of pain and temp
Atlanto Occipital Dislocation - CORRECT-ANSWERSthis is commonly seen in
shaken baby syndrome due to severe traumatic flexion and distraction. Most
patients with this injury die of brainstem destruction and apnea or have
profound neurological impairments.
Jefferson Fracture - CORRECT-ANSWERSBurst fracture of C1 due to axial
loading, which occurs when a large load falls vertically on the head in a
relatively neutral position. Disruption of anterior and posterior rings of C1
Fracture best seen on an open mouth view of the C1-C2 region on CT
Hangman Fracture - CORRECT-ANSWERSthis involves the posterior elements
of C2, the pars interarticularis and this type of fracture is caused by an
extension type injury
Chance Fracture - CORRECT-ANSWERStransverse fractures through the
vertebral body seen after MVC where patient was restrained by only an
improperly placed lap belt.
Chance fractures can be associated with retroperitoneal and abdominal
visceral injuries. these are unstable and require internal fixation
NEXUS - CORRECT-ANSWERSNeurological deficit
ethanol intoxication
distracting injury
unable to provide history
spinal tenderness midline
Signs of blood loss in a child - CORRECT-ANSWERSprogressive weakening of
peripheral pulses, narrowing pulse pressure less than 20, skin mottling
(clammy skin), cool extremities compared with torso skin, decrease in level
of consciousness with dulled response to pain.
often times tachycardia may be the only sign of shock in a kid
hypotension in child - CORRECT-ANSWERSsystolic BP for kid is 90 + twice the
child's age in years. hypotension represents a state of decompensated shock
and can indicated blood loss of > 45%.
, True or false? Although the mechanism of injury may be similar to those for
the younger population, data shows increased mortality with similar severity
of injury in older adults. - CORRECT-ANSWERSTrue
In the elderly population, what is decreased physiological reserve? -
CORRECT-ANSWERSaging is characterized by impaired adaptive and
homeostatic mechanisms that caused an increased susceptibility to the
stress of injury. Insults tolerated by the younger population can lead to
devastating results in elderly patients.
Pre-existing conditions that affect morbidity and mortality include: -
CORRECT-ANSWERScirrhosis, coagulopathy, COPD, ischemic heart disease,
DM
What is the most common mechanism of injury in the elderly? - CORRECT-
ANSWERSFall. Nonfatal falls are common in women and fractures are
common in women who fall. Falls are the most common cause of TBI.
In the elderly population, what are risk factors for falls? - CORRECT-
ANSWERSadvanced age, physical impairment, history of previous fall,
medication use, dementia, unsteady gait, and visual, cognitive impairment
Most of elderly traffic fatalities occur in the daytime and on weekends and
typically involve other vehicles. Why? - CORRECT-ANSWERSOlder people
drive on more familiar roads and at lower speeds and tend to drive during
the day. Older people have slower reaction time, a larger blind spot, limited
cervical mobility, decreased hearing, and cognitive impairment.
True or False? Mortality associated with small to moderate sized burns in
older adults remains high - CORRECT-ANSWERSTrue
Spilled hot liquids on the leg, which in younger patients may re-epithelialize
due to an adequate number of hair follicles, will result in a full thickness burn
in older patients. - CORRECT-ANSWERSthis is true
Airway-patients may have dentures that may loosen or obstruct the airway.
If dentures are not obstructing the airway, leave them in place for what? -
CORRECT-ANSWERSbag mask ventilation, as it improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos,
barbiturates, and other sedatives should be reduced to what percentage to
minimize the risk of cardiovascular depression? - CORRECT-ANSWERS20-40%
Functional changes in cardiac system include declining function, decreased
sensitivity to catecholamines, atherosclerosis of coronary vessels, increased
afterload, fixed heart rate (beta blockers) - CORRECT-ANSWERSthis results in
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