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EFMB Written Exam Study Guide
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EFMB Written Exam Study GuideSection 1 - Radiology: Imaging Trauma Patients in a Deployed Setting - VERIFIED ANSWER -
The initial radiographic evaluation of a trauma patient begins with supine Anterior-Posterior (AP)
chest and pelvis radiographs taken in the trauma bay usually with a(n) __________. - VERIFIED
ANSWER portable x-ray machine
T/F: Computed Tomography scanning has been largely replaced by Cervical Spine Radiographic
Evaluation (CSRE) and should only be performed when CSRE is unavailable. - VERIFIED ANSWER
FALSE. Cervical Spine Radiographic Evaluation (CSRE) has been largely replaced by Computed
Tomography (CT) and should only be performed when a CT is unavailable.
What is the lowest level of care equipped with a Computed Tomography (CT) Scanner? - VERIFIED
ANSWER Role 3
What is the lowest level of care equipped with a portable x-ray machine? - VERIFIED ANSWER Role 2
Members of the trauma team should have __________ aprons and thyroid shields available near the
trauma bay for radiation safety. - VERIFIED ANSWER lead
Distance is also protective from radiation exposure. If feasible based on the patient's condition, any
personnel without lead shielding should move a short distance away from the x-ray unit. The
recommended minimal distance is __________ feet. - VERIFIED ANSWER Six (6)
While the FAST scan has been validated only in hemodynamically unstable blunt trauma patients, it
has become a standard tool in the trauma bay and Emergency Department (ED) in most trauma
patients. FAST stands for __________. - VERIFIED ANSWER Focused Abdominal Sonographic
Assessment for Trauma
FAST in combat trauma has a sensitivity of only 56% and and specificity of __________. - VERIFIED
ANSWER 98%
T/F: The FAST exam remains the most sensitive test for hollow viscus injury and mesenteric injury. -
VERIFIED ANSWER FALSE. Diagnostic Peritoneal Lavage (DPL) remains the most sensitive test for
hollow viscus injury and mesenteric injury.
,T/F: At the Role 3, properly trained providers including radiologists, surgeons, and emergency
physicians, can perform and interpret FAST scVERIFIED ANSWER in the emergency department on a
hand held portable US device. - VERIFIED ANSWER TRUE
A FAST examination is performed with a portable hand-held machine most commonly using a
standard 3-7 MHz curved array __________ probe. - VERIFIED ANSWER Ultra Sound (US)
The standard FAST examination is focused on evaluating for the presence of __________ in certain
areas of the body. - VERIFIED ANSWER Free Intraperitoneal Fluid
When performing a FAST examination on a patient, you inspect the right upper quadrant. You are
inspecting between which two (2) organs? - VERIFIED ANSWER Liver & Kidney
When performing a FAST examination on a patient, you inspect the left upper quadrant. You are
inspecting between which two (2) organs? - VERIFIED ANSWER Spleen & Kidney
An 18g __________ IV is typically desired for Computed Tomography IV access. - VERIFIED ANSWER
antecubital
T/F: The goal of Computed Tomography (CT) contrast injection is to provide concurrent solid organ
enhancement, arterial enhancement, and pulmonary arterial. - VERIFIED ANSWER TRUE
T/F: When performing Computed Tomography (CT) scan on a Military Working Dog, utilize a
scanning protocol based on the adult settings to include the doses of and rates of contrast
administration. - VERIFIED ANSWER FALSE. Utilize a scanning protocol based on the pediatric
settings to include the doses of and rates of contrast administration.
T/F: All patients evacuated through casualty evacuation should have images sent electronically
ahead of time as well as have a CD created to send with the patient as a backup. - VERIFIED ANSWER
TRUE
T/F: Magnetic Resonance Imaging (MRI) is widely used in theater, as its utility in the acute
management of combat trauma was extensively established during Operation Enduring Freedom. -
VERIFIED ANSWER FALSE. While Magnetic Resonance Imaging (MRI) has been deployed to theater in
the past, its utility in the acute management of combat trauma has not been established.
,All trauma patients arriving at a Role __________ hospital will receive proper and expeditious
radiologic screening of injuries. - VERIFIED ANSWER 3
Section 2: Aural Blast Injury Acoustic Trauma & Hearing Loss - VERIFIED ANSWER -
T/F: Patients exposed to hazardous noise are only at risk for aural trauma. - VERIFIED ANSWER
FALSE. Service Members exposed to hazardous noise is impact noise or noise greater than 140 dB
are at high risk for acoustic trauma and subsequent hearing loss. Patients exposed to blasts are at
risk for both aural and acoustic trauma.
The symptoms of acoustic trauma are: - VERIFIED ANSWER 1. Hearing Loss
2. Tinnitus (Ringing in the Ear)
3. Aural Fullness
4. Recruitment (Ear Pain with Loud Noise)
5. Difficulty Localizing Sounds
6. Difficulty Hearing in a Noisy Background
7. Vertigo
"H-TARDD-V"
Acoustic trauma may result in sensorineural hearing loss (SNHL) that is either __________ or
__________. - VERIFIED ANSWER temporary (temporary threshold shift, TTS) or permanent
(permanent threshold shift, PTS)
The ear, specifically the __________, is the most sensitive organ to primary blast injury (PBI). -
VERIFIED ANSWER tympanic membrane (TM)
T/F: the smaller the size of the tympanic membrane perforation, the greater the likelihood is of
spontaneous closure. - VERIFIED ANSWER TRUE
The majority of tympanic membrane perforations that close spontaneously do so within the first
__________ after injury. - VERIFIED ANSWER 8 weeks
, Acute management of intratemporal facial nerve injury is to provide objective documentation of
facial movement using the __________ grading scale. - VERIFIED ANSWER House-Brackmann
T/F: For significant facial pareses/paralyses, early administration of steroids must always be provided
regardless of contraindications. - VERIFIED ANSWER FALSE. Early administration of steroids should
be provided if not contraindicated, and referral for management by an otolaryngologist is indicated.
Which inner ear abnormalities may cause vertigo? - VERIFIED ANSWER 1. Otic Capsule Violating
Temporal Bone Fractures
2. Secondary Infections of the Inner Ear or Vestibular Nerves
3. Trauma Induced Endolymphatic Hydrops
4. Activation of Subclinical Super Semicircular Canal Dehiscence
"OSTA"
All Service Members that develop symptoms consistent with noise trauma (acute tinnitus, muffled
hearing, fullness in the ear) should... - VERIFIED ANSWER ...be educated and directed to self-report
for evaluation and possible treatment as soon as practicable.
What is the best course of action if you find debris in the External Auditory Canal (EAC) or in the
middle ear (as seen through a TM perforation)? - VERIFIED ANSWER Treat the patient with a
fluoroquinolone and steroid containing topical antibiotic (e.g., four (4) drops of
ciprofloxacin/dexamethasone or ofloxacin in the affected ear three (3) times a day for seven (7)
days. Do not irrigate the ear as it may provoke pain and vertigo.
Hearing loss that persists __________ hours after acoustic trauma warrants a hearing test or
audiogram. - VERIFIED ANSWER 72 hours
T/F: Vestibular trauma to the inner ear may manifest in vertigo. - VERIFIED ANSWER TRUE
All patients with subjective hearing loss and tinnitus following blast exposure should... - VERIFIED
ANSWER ...have the exposure documented, and should be evaluated by hearing testing as soon as
possible
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