ATLS g10thgEditiongPostgTestg1g

1g/g99

• WhichgofgthegfollowinggisgthegrecommendedgMethodgforgtrestemtgfrostbite?
• Vasodilators
• Anticigulants
• Warm g(40gdegrees)gwater
• Paddinggandgelevation

E. Applicationgofgheatgfromgaghairdryer:

gAnswer>gC.gWarmg(40gdegrees)gwater

• Whichgofgthegfollowinggphysicalgfindingsgsuggestgagcausegofghypotensiongothergthangs

pinalgcordginjury?

• Prispism
• Bradycardia

ATLS g10thgEditiongPostgTestg1g gQuestionsgandg gAnswersg gCorrectg gGradeg

2g/g99

• Diaphragmaticgbreathing
• Presencegofgdeepgtendongreflexes
• Abilitygtogflexgforearmsgbutgnotgextendgthemg

Answer>:gD.gPresencegofgdeepgtendongreflexes.gSpinalgshockgrefersgtoglossgofgmusclegtoeg(fla ccidty)gandglossgofgreflexes.

• ThegprimarygindicationgforgtransferringgAgpatientgtogaghigherglevelgtraumagcentergis

:

• Unavailibilitygofgsurgeongorgoperatinggstaff
• Multiplegsystemginjuries,gincludinggseveregheadginjury
• Resourceglimitationsgasgdeterminedgbygthegtransferringgdoctor
• Resourceglimitationsgasgdeterminedgbygtheghospitalgadministration

E. Widenedgmediastinumgongchestgx-raygfollowinggbluntgtrauma:g

Answer>ggC.gResourceglimitationsgasgdeterminedgbygthegtransferringgdoctorg(MÃ…gSJEKKES)

• Agyounggmangsustainsgagriflegwoundgtogthegmid-

abdomen.gHegisgbroughtgpromptlygtogthegEDgbygprehospitalgpersonnel.gHisgskingisgcoolgand gdiaphoretic,gandghisgsystolicgbloodgpressuregisg58mmHg. gWarmed gcrystalloidgfluidsgaregi nitiatedgwithoutgimprovementginghisgvitalgsigns.gThegnext,gmostgappropriate,gstepgisgtogpe

rform:

• aglaparotomy

3g/g99

• AngabdominalgCT-scan
• Diagnosticglaparoscopy
• Abdominalgultrasonography

E. Agdiagnosticgperitonealglavage:

gAnswer>ggA.gLaparotomygbecausegofghemodynamicgab-gnormality

• Ag42-year-

oldgmangisgtrappedgfromgthegwaistgdowngbeneathghisgoverturnedgtractorgforgseveralghour sgbeforegmedicalgassistancegarrives.gHegisgawakegandgalertguntilgjustgbeforegarrivinggingtheg ED.gHegisgnowgunconsciousgandgrespondsgonlygtogpainfulgstimuligbygmoaning.gHisgpupilsga reg3mm gingdiametergandgsymmetricallygreactivegtoglight.gPrehospitalgpersonnelgindicategt hatgtheyghave

notgseengthegpatientgmovegeithergofghisglowergextremities.gOngexaminationgingthegED,gnogm ovementgofghisglowergextremitiesgaregdetected,gevengingresponsegtogpainfulgstimuli.gThegmos

tglikelygcausegforgthisgfindinggis:

• Angepiduralghematoma
• Agpelvicgfracture
• Centralgcordgsyndrome
• Intracerebralghemorrhage

4g/g99

E. Bilateralgcompartmentgsyndrome:

gAnswer>gDgMÃ…gSJEKKES

• Ag6-year-

ogboygisgstruckgbygangautomobilegandgbroughtgtogthegED.gHegisglethargic,gbutgwithdrawsgp urposefullygfromgpainfulgstimuli.gHisgbloodgpressuregisg90mmHg gsystolic,gheartgrateg140gb eatsgpergminutegandghisgrespiratorygrategisg36gbreathsgpergminute.gThegpreferredgroutegofg

venousgaccessgingthisgpatientgis:

• Percutaneousgfemoralgveingcannulation
• Cutdowngongthegsaphenousgveingatgthegankle
• Intraosseousgcathetergplacementgingthegproximalgtibia
• Percutaneousgperipheralgveinsgingtheguppergextremities

E. Centralgvenousgaccessgviagthegsubclaviangorginternalgjugulargvein:

gAnswer>ggD.gPercu-gtaneousgperipheralgveinsgingtheguppergextremities

• Agyounggmangsustainsgaggunshotgwoundgtogthegabdomengandgisgbroughtgpromptlygtogth

egEDgbygprehospitalgpersonnel.gHisgskingisgcoolgandgdiaphoretic,gandghegisgconfused.gHisgpu lsegisgthreadygandghisgfemoralgpulsegisgonlygweaklygpalpable.gThegdefinitivegtreatmentging

managinggthisgpatientgisgto:

• AdministergO-negativegblood
• Applygexternalgwarminggdevices