sample of questions
here is a sample of the questions students get in their exam:
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood pressure is initially 80/40 mm Hg. After 2 liters of crystalloid solution his blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute. His breath sounds are decreased in the left hemithorax, and after initial IV fluid resuscitation, a closed tube thoracostomy is performed for decreased left breath sounds with the return of a small amount of blood and no air leak. After chest tube insertion, the most appropriate next step is
a.re-examine chest
b.perform aortogram
c.get a CT of chest
d.obtain ABG
e.perform TEE
answer: A
Cervical spine injury
a. is excluded by a normal neurologic examination.
b. is not present if the patient has normal range of neck motion.
c. can be detected safely by careful flexion and extension of the neck.
d.can be excluded by a crosstable lateral roentgenogram of the c-spine.
e.may be first manifested by neurologic deficit after movement of the neck.
Answer: E
Which one of the following statements concerning intraosseous infusion in children is TRUE?
a. Only crystalloid solutions may be safely infused through the needle.
b. Aspiration of bone marrow confirms appropriate positioning of the needle.
c. Intraosseous infusion is the preferred route for volume resuscitation in small children.
d. Intraosseous infusion may be utilized indefinitely in the management
of injured children.
e. Swelling in the soft tissue around the intraosseous site is not a reason to discontinue infusion.
answer: B
A patient is brought to the emergency department 20 minutes after a motor vehicular crash. He is conscious and there is no obvious external trauma. He arrives at the hospital intubated and completely immobilized on a long spine board. His blood pressure is 60/40 and his pulse rate is 70 beats per minute. His skin is warm and he has no rectal tone. Which one of the following statements is TRUE?
a.Vasoactive medications have no role in early management.
b.The hypotension should be managed with volume resuscitation alone.
c. Flexion and extension views of the c-spine should be performed early.
d.Occult abdominal visceral injuries can be excluded as a cause of hypotension.
e. Flaccidity of the lower extremities and loss of deep tendon reflexes are expected.
answer: E
Which one of the following findings should prompt immediate management during the primary survey?
a.Distended abdomen
b. Glasgow Coma Scale Score of 11
c. Pulse rate of 120 beats per minute
d.Temperature of 36.5' C (97.8' F)
e. Respiratory rate of 32 breaths per minute.
answer:E