EXAM WITH CORRECT SOLUTIONS.

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ATLS TEST EXAM

EXAM WITH CORRECT 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 answer- True

In the elderly population, what is decreased physiological reserve? - correct answer- 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 answer- cirrhosis, coagulopathy, COPD,

ischemic heart disease, DM

What is the most common mechanism of injury in the elderly? - correct answer- Fall. Nonfatal falls are common in women and fractures are common in women who fall. Falls are the most common cause of TBI.

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In the elderly population, what are risk factors for falls? - correct answer- 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 answer- 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 answer- 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 answer- 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 answer- bag mask ventilation, as it improves mask fitting. 2 / 4

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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 answer- 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 answer- 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 answer- 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 answer- resulting in drug dosing for renal insufficiency, decreased ability to concentrate urine, increased risk for AKI and urine flow may be normal with hypovolemia

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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 answer- 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 answer- 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 answer- true

In elderly population, due to their changes in pulmonary system, placing a gauze between 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 answer- respiratory failure may present insidiously in older adults.

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