2024 Atls Exam With Questions And Complete Solutions
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 Ans- True
In the elderly population, what is decreased physiological reserve?
{{Correct Ans- aging 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 Ans- cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly?
{{Correct Ans- Fall. 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 Ans- advanced 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 Ans- Older 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 Ans- True
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 Ans- this 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 Ans- bag 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 Ans- 20-40%
Functional changes in cardiac system include declining function, decreased sensitivity to
catecholamines, atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta
blockers) {{Correct Ans- this results in lack of classic response to hypovolemia, risk for cardiac
ischemia, elevated BP at baseline, and increased risk of dysrythmias.
Functional changes in pulmonary system include decreased elastic recoil, reduced residual
capacity, decreased gas exchange and decreased cough reflex
{{Correct Ans- thus they are at increased risk for respiratory failure, increased risk for pneumonia,
and poor tolerance to rib fractures
Functional changes in renal system include loss of renal mass, decreased GFR, and decreased
sensitivity to ADH and aldosterone
{{Correct Ans- resulting in drug dosing for renal insufficiency, decreased ability to concentrate
urine, increased risk for AKI and urine flow may be normal with hypovolemia
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints and
cartilage, c spine degenerative changes and loss of skin elastin and subcutaneous fat
{{Correct Ans- resulting in increased risk for fractures, decreased mobility, difficulty for oral
intubation, risk of skin injury, increased risk for hypothermia, challenges in rehabiliation
Functional changes in Endocrine system include decreased production and response to thyroxin
and decreased dehydroepiandrosterone (DHEA)
{{Correct Ans- resulting in occult hypothyroidism, relative hypercortisone states and increased
risk of infection
True or false: Arthritis can complicate the airway and cervical spine. Patients can have multilevel
degenerative changes affecting disk spaces and posterior elements associated with severe central
canal stenosis, cord compression, and myelomalacia
{{Correct Ans- true
In elderly population, due to their changes in pulmonary system, placing a gauze betwee n gums
and cheek to achieve seal when using bag valve mask ventilation is okay. In addition, because aging
causes a suppressed heart rate response to hypoxia......
{{Correct Ans- respiratory failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at
significant risk for being inaccurately categorized as hemodynamically stable.
, {{Correct Ans- Elderly patients have a fixed heart rate and fixed cardiac output, thus, their response
to hypovolemia will involve increasing their systemic vascular resistance. Furthermore, since older
patients have HTN, an acceptable BP may truly reflect a hypotensive state. A systolic BP of 110 is to
be utilized as the threshold for identifying hypotension in patients 65 and older.
Do no equate blood pressure with shock in older patients
{{Correct Ans- BP in older patients may look normal due to the medications they are on. Use
lactate and base deficit to evaluate for evidence of shock
what 2 factors place elderly patients at risk for intracranial hemorrhage?
{{Correct Ans- aging causes dura to become more adherent to the skull increasing risk of injury and
older patients are on anticoagulant and antiplatelet medications.
Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions place elderly
patients as risk for hypothermia and complications for immobility.
{{Correct Ans- Rapid evaluation and when possible early liberation from spine boards and cervical
collars will minimize complications.
True or False: Fall prevention is the mainstay of reducing the mortality associated with pelvic
fractures. {{Correct Ans- true
poor hygiene, dehydration, oral injury, contusions affecting the inner arms, inner thighs, palms,
soles, scalp, ear, nasal bridge and temple injury from being struck while wearing glasses, contact
burns and scalds. These are all signs of. ?
{{Correct Ans- Elder maltreatment. The presence of physical findings of maltreatment should prompt
a detailed history. if history conflicts with findings, immediately report findings to authorities.
True of false: early activation of the trauma team may be required for elderly patients who do not
meet traditional criteria for activation
{{Correct Ans- True. A simple injury such as an open tibia fracture in a frail elderly patient may
become life threatening.
Common mechanisms of injury include falls, MVC, burns, and penetrating injuries
{{Correct Ans- common injuries in the elderly include rib fractures, TBI, pelvic fractures
The best initial treatment for the fetus is to provide optimal resuscitation of the mother. True or
False? {{Correct Ans- True. Also if xray examination is indicated during the pregnant patient's
treatment, it should not be withheld because of the pregnancy.
What happens as the uterus enlarged and the bowel is pushed cephalad.
{{Correct Ans- When the uterus enlarges it pushes the bowel cephalad and the uterus lies in the
abdomen. As a result, the bowel is somewhat protected from blunt abdominal trauma, whereas
the
