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ATLS EXAM with complete Questions and Answers 2024.
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ATLS EXAM with complete Questions and Answers2024
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.
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 peop
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.
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
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.
Age related changes in the cardiovascular system place the elderly trauma patient at significant risk for being inaccurately categorized as
hemodynamically stable. - Correct Answer - Elderly patients have a fixed heart rate and fixed cardiac output, thus, their response to
hypovolemia will involve increasing their systemic vascular resistance. Furthermore, since older patients have HTN, an acceptable BP may trul
reflect a hypotensive state. A systolic BP of 110 is to be utilized as the threshold for identifying hypotension in patients 65 and older.
Do no equate blood pressure with shock in older patients - Correct Answer - BP in older patients may look normal due to the medications they
are on. Use lactate and base deficit to evaluate for evidence of shock
what 2 factors place elderly patients at risk for intracranial hemorrhage? - Correct Answer - aging causes dura to become more adherent to the
skull increasing risk of injury and older patients are on anticoagulant and antiplatelet medications.
Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions place elderly patients as risk for hypothermia and complications fo
immobility. - Correct Answer - Rapid evaluation and when possible early liberation from spine boards and cervical collars will minimize
complications.
True or False: Fall prevention is the mainstay of reducing the mortality associated with pelvic fractures. - Correct Answer - true
poor hygiene, dehydration, oral injury, contusions affecting the inner arms, inner thighs, palms, soles, scalp, ear, nasal bridge and temple injury
from being struck while wearing glasses, contact burns and scalds. These are all signs of.......? - Correct Answer - Elder maltreatment. The
presence of physical findings of maltreatment should prompt a detailed history. if history conflicts with findings, immediately report findings to
authorities.
True of false: early activation of the trauma team may be required for elderly patients who do not meet traditional criteria for activation - Correct
Answer - True. A simple injury such as an open tibia fracture in a frail elderly patient may become life threatening.
Common mechanisms of injury include falls, MVC, burns, and penetrating injuries - Correct Answer - common injuries in the elderly include rib
fractures, TBI, pelvic fractures
The best initial treatment for the fetus is to provide optimal resuscitation of the mother. True or False? - Correct Answer - True. Also if xray
examination is indicated during the pregnant patient's treatment, it should not be withheld because of the pregnancy.
What happens as the uterus enlarged and the bowel is pushed cephalad. - Correct Answer - When the uterus enlarges it pushes the bowel
cephalad and the uterus lies in the upper abdomen. As a result, the bowel is somewhat protected from blunt abdominal trauma, whereas the
uterus and its contents (fetus and placenta) become more vulnerable. Uterus remains intrapelvic until 12 weeks and then at 20 weeks it is at th
umbilicus, and at 34-36 weeks it reaches the costal margin.
Amniotic fluid can cause amniotic fluid embolism and disseminated intravascular coagulation following trauma if fluid enters maternal
intravascular space. True or False - Correct Answer - True
By the third trimester, what is the complication of trauma to the pelvis of the mother? - Correct Answer - by the third trimester, the uterus is larg
and thin walled. In vertex presentation, fetal head is usually in the pelvis and the remainder of the fetus is exposed above the pelvic brim. Pelvic
fractures in late gestation can result in skull fracture or intracranial injury to the fetus. Also we can have a placental abruption due to its little
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