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Tcrn Exam Questions With Correct Detailed Answers
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Tcrn Exam Questions With Correct Detailed Answers
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Tcrn Exam Questions With CorrectDetailed Answers
Shock - ANSWER- Lack of oxygen to the cells
Hypovolemic Shock - ANSWER- Lack of volume
ex: hemorrhage, burns
Distributive Shock - ANSWER- Maldistribution of blood (pooled in extremities)
Decreased preload
ex: neurogenic shock
Cardiogenic Shock - ANSWER- Inadequate cardiac output
ex: blunt cardiac trauma
Obstructive Shock - ANSWER- Inability of blood to enter or exit heart properly
ex: tamponade, tension pneumothorax
Systemic Inflammatory Response Syndrome (SIRS) - ANSWER- Severe tissue trauma
activates an inflammatory response leading to vasodilation, capillary permeability, and
coagulation
Early (Compensated) Shock - ANSWER- Normal BP
Weak, thready pulse
Deep and rapid RR
Normal lactic levels
Anxious
Late (Decompensated) Shock - ANSWER- Decreased BP
Tachycardia
Shallow and rapid RR
Increased Lactic
Decreased LOC
Decreased urinary output
BUN to Creatinine Ratio - ANSWER- Normal - 10:1
Indicated effective renal function
Trauma Triad of Death - ANSWER- Hypothermia
Acidosis
Coagulopathies
Effects of Acidosis - ANSWER- Increased ICP
,Exacerbates coagulopathies
Depressed myocardial contractility
DIC - ANSWER- Excessive clotting > all clotting factors used > no more clotting >
excessive bleeding
Effects of coagulopathies - ANSWER- Decreased platelet count
Decreased fibrinogen
Decreased HnH
Increased PT, PTT
Increased Ddimer
Multi-Organ Dysfunction Syndrome (MODS) - ANSWER- Irreversible Shock resulting
from Triad of Death
Symptoms start within the first week after trauma
Steps to control hemorrhage - ANSWER- Tourniquet
TXA
REBOA
Permissive Hypotension
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) - ANSWER-
Occlusion of the Aorta below the diaphragm to reduce bleeding
Type A - ANSWER- RBC: Type A, O
Plasma: Type A, AB
Type B - ANSWER- RBC: Type B, O
Plasma: Type B, AB
Type AB - ANSWER- RBC: Type A, B, AB, O
Plasma: AB
Type O - ANSWER- RBC: Type O
Plasma: Type A, B, AB, O
Universal Donor of RBC and Plasma - ANSWER- Universal donor of RBC: O negative
Universal donor of Plasma: AB negative
Cryoprecipitate - ANSWER- Concentrate of coagulation factors obtained from fresh
frozen plasma
Increases fibrinogen in the bloodstream
Blood Transfusion in Peds - ANSWER- One unit of blood is 10ml/kg
Complications of MTP - ANSWER- Hypothermia - warm all fluids and blood
, Hypocalcemia - replace calcium
Acidosis - sodium bicarb
TRALI - stop transfusion, supplemental oxygen
Transfusion-Related Acute Lung Injury (TRALI) - ANSWER- Pulmonary edema due to
rapid blood administration
MTP Protocol - ANSWER- 1 : 1 : 1
RBC : Plasma : Platelet
Blood Loss Grades - ANSWER- I - Loss of 15% with normal BP
II - Loss of 15-30% with normal BP
III - Loss: of 31-40% with lowered BP
IV - Loss > 40% with hemodynamic instability
Permissive Hypotension - ANSWER- Maintaining BP as low as 70/40 so allow for
clotting.
Contra-indicated in head injuries, peds, and elderly
SCIWORA - ANSWER- Spinal Cord Injury WithOut Radiological Abnormality
Common in Age < 2 yrs
Significance of Bariatric Patients - ANSWER- Increased HR and RR at baseline
Increased abdominal pressures
Increased risk of coagulopathies
SBIRT - ANSWER- Comprehensive intervention to deliver treatment for substance use
disorders
Screening
Brief Intervention
Referral to Treatment
Triad of Abusive Brain Injury - ANSWER- Subdural Hemorrhage
Retinal Hemorrhage
Decreased LOC
Types of Stress Disorders - ANSWER- State of Crisis - Immediately after event
Acute Stress Disorder - Lasting at least three days
Post Traumatic Stress Disorder - Lasting one month or longer
Three things to identify state of crisis - ANSWER- 1. Perception of the event
2. Support System
3. Coping mechanisms
Steps of Research - ANSWER- 1. Research question
2. Literature Review
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