1. Cardiac tamponade after trauma
a. is seldom life-threatening
b. can be excluded by an upright, AP chest x-ray
c. can be confused with a tension
... [Show More] pneumothorax
d. causes a fall in systolic pressure of > 15 mm Hg with expiration
e. most commonly occurs after blunt injury to the anterior chest wall
2. Which one of the following statements regarding patients with
thoracic spine injuries is TRUE?
a. Log-rolling may be destabilizing to fractures from T-12 to L-1.
b. Adequate immobilization can be accomplished with the scoop
stretcher.
c. Spinal cord injury below T-10 usually spares bowel and bladder
function.
d. Hyperflexion fractures in the upper thoracic spine are
inherently unstable.
e. These patients rarely present with spinal shock in association
with cord injury.
3. Absence of breath sounds and dullness to percussion over the left
hemithorax are fmdings best explained by
a. Left
hemothorax. b.
c.
d.
e.
f.
g. cardiac contusion
h. left simple pneumothorax
i. left diaphragmatic rupture
j. right tension pneumothorax.
4. A young man sustains a gunshot wound to the abdomen and is
brought promptly to the emergency department by prehospital
personnel. His skin is cool and diaphoretic, and he is confused. His
pulse is thready and his femoral
pulse is only weakly palpable. The defmitive treatment in managing
this patient is to
a. administer 0-negative blood
b. applyextemal warming devices.
c. Control internal hemorrhage operatively
d. apply the pneumatic antishock garment
e. infuse large volumes of intravenous crystalloid solution.
5. To establish a diagnosis of shock,
a. systolic blood pressure must be below 90 mm Hg.
b. the presence of a closed head injury should be excluded
c. acidosis should be present by arterial blood \gas analysis
d. the patient must fail to respond to intravenous fluid infusion.
e. clinical evidence of inadequate organ perfusion must
be present.
6. A 23-year-old man is brought immediately to the emergency
department from the hospital' s parking lot where he was shot in the
lower abdomen. Examination reveals a single bullet wound. He is
breathing and has a thready pulse. However, he is unconscious and
has no detectable blood pressure.
Optimal immediate management is to
a. perform diagnostic peritoneal lavage.
b. initiate infusion of packed red blood cells.
c. insert a nasogastric tube and urinary catheter.
d. transfer the patient to the operating room, while
initiating fluid therapy.
e. initiate fluid therapy to return his blood pressure to normotensive
7. An electrician is electrocuted by a downed power line after a
thunderstorm. He apparently made contact with the wire at the level
of the right mid thigh. In the emergency department, his vital signs
are normal and no dysrhythmia is noted on ECG. On examination,
there is an exit wound on the bottom of the right foot. His urine is
positive for blood by dip stick but no RBCs are seen microscopically.
Initial management should include
a. immediate angiography.
b. aggressive fluid infusion.
c. intravenouspyleography.
d. debridement of necrotic muscle.
e. admission to the intensive care unit for observation.
8. An 8-year-old girl is an unrestrained passenger in a vehicle struck
from behind. In the emergency department, her blood pressure is
80/60 mm Hg, heart rate is 80 beats per minute, and respiratory
rate is 16 breaths per minute. Her GCS score is 14. She complains
that her legs feel "funny and won't move right;" however, her spine
x-rays do not show a fracture or dislocation. A spinal cord injury in
this child
a. is most likely a central cord syndrome.
b. must be diagnosed by magnetic resonance imaging.
c. can be excluded by obtaining a CT of the entire spine.
d. may exist in the absence of objective findings on x-ray
studies.
e. is unlikely because of the incomplete calcification of the vertebral
bodies.
9. Immediate chest tube insertion is indicated for which of the
following conditions?
a. Pneumothorax
b. Pneumomediastinum
c. Massive hemothorax
d. Diaphragmatic rupture
e. Subcutaneous emphysema
10. A 32-year-old man is brought to the hospital unconscious with severe
facial injuries and noisy respirations after an automobile collision. In
the emergency department, he has no apparent injury to the anterior
aspect of his neck. He suddenly becomes apneic, and attempted
ventilation with a face mask is unsuccessful. Examination of his
mouth reveals a large hematoma of the
pharynx with loss of normal anatomic landmarks. Initial management
of his airway should consist of
a. inserting an oropharyngealairvvay.
b. inserting a nasopharyngeal airway.
c. performing a surgical cricothyroidotomy.
d. performingfiberoptic-guided nasotracheal intubation.
e. performingorotracheal intubation after obtaining a lateral c-spine xray. [Show Less]