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Exam (elaborations)

ATLS EXAM QUESTIONS WITH COMPLETE SOLUTIONS

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ATLS EXAM QUESTIONS WITH COMPLETE SOLUTIONS

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  • August 7, 2024
  • 22
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • ATLS
  • ATLS
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AGRADEPROMASTER
ATLS EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
Trueaorafalse?aAlthoughatheamechanismaofainjuryamayabeasimilaratoathoseaforatheayoungerap
opulation,adataashowsaincreasedamortalityawithasimilaraseverityaofainjuryainaolderaadults.a-
acorrectaanswera✔✔True




Inatheaelderlyapopulation,awhataisadecreasedaphysiologicalareserve?a-
acorrectaanswera✔✔agingaisacharacterizedabyaimpairedaadaptiveaandahomeostaticamechan

ismsathatacausedaanaincreasedasusceptibilityatoatheastressaofainjury.aInsultsatoleratedabyathe
ayoungerapopulationacanaleadatoadevastatingaresultsainaelderlyapatients.




Pre-existingaconditionsathataaffectamorbidityaandamortalityainclude:a-
acorrectaanswera✔✔cirrhosis,acoagulopathy,aCOPD,aischemicaheartadisease,aDM




Whataisatheamostacommonamechanismaofainjuryainatheaelderly?a-
acorrectaanswera✔✔Fall.aNonfatalafallsaareacommonainawomenaandafracturesaareacommonai

nawomenawhoafall.aFallsaareatheamostacommonacauseaofaTBI.

Inatheaelderlyapopulation,awhataareariskafactorsaforafalls?a-
acorrectaanswera✔✔advancedaage,aphysicalaimpairment,ahistoryaofapreviousafall,amedicatio

nause,adementia,aunsteadyagait,aandavisual,acognitiveaimpairment

Mostaofaelderlyatrafficafatalitiesaoccurainatheadaytimeaandaonaweekendsaandatypicallyainvolv
eaotheravehicles.aWhy?a-
acorrectaanswera✔✔Olderapeopleadriveaonamoreafamiliararoadsaandaataloweraspeedsaandate

ndatoadriveaduringatheaday.aOlderapeopleahaveaslowerareactionatime,aaalargerablindaspot,alim
itedacervicalamobility,adecreasedahearing,aandacognitiveaimpairment.

TrueaoraFalse?aMortalityaassociatedawithasmallatoamoderateasizedaburnsainaolderaadultsare
mainsahigha-acorrectaanswera✔✔True

Spilledahotaliquidsaonathealeg,awhichainayoungerapatientsamayare-
epithelializeadueatoaanaadequateanumberaofahairafollicles,awillaresultainaaafullathicknessaburna
inaolderapatients.a-acorrectaanswera✔✔thisaisatrue

Airway-
patientsamayahaveadenturesathatamayaloosenaoraobstructatheaairway.aIfadenturesaareanotaob
structingatheaairway,aleaveathemainaplaceaforawhat?a-
acorrectaanswera✔✔bagamaskaventilation,aasaitaimprovesamaskafitting.

,Whenapreformingarapidasequenceaintubation,atheadoseaofabenzos,abarbiturates,aandaothera
sedativesashouldabeareducedatoawhatapercentageatoaminimizeatheariskaofacardiovascularade
pression?a-acorrectaanswera✔✔20-40%

Functionalachangesainacardiacasystemaincludeadecliningafunction,adecreasedasensitivityatoa
catecholamines,aatherosclerosisaofacoronaryavessels,aincreasedaafterload,afixedaheartarate
a(betaablockers)a-


acorrectaanswera✔✔thisaresultsainalackaofaclassicaresponseatoahypovolemia,ariskaforacardiac

aischemia,aelevatedaBPaatabaseline,aandaincreasedariskaofadysrythmias.




Functionalachangesainapulmonaryasystemaincludeadecreasedaelasticarecoil,areducedaresid
ualacapacity,adecreasedagasaexchangeaandadecreasedacoughareflexa-
acorrectaanswera✔✔thusatheyaareaataincreasedariskaforarespiratoryafailure,aincreasedariskafo

rapneumonia,aandapooratoleranceatoaribafractures

Functionalachangesainarenalasystemaincludealossaofarenalamass,adecreasedaGFR,aandadecr
easedasensitivityatoaADHaandaaldosteronea-
acorrectaanswera✔✔resultingainadrugadosingaforarenalainsufficiency,adecreasedaabilityatoaco

ncentrateaurine,aincreasedariskaforaAKIaandaurineaflowamayabeanormalawithahypovolemia

FunctionalachangesatoaMSKaincludealossaofaleanabodyamass,aosteoporosis,achangesainajoin
tsaandacartilage,acaspineadegenerativeachangesaandalossaofaskinaelastinaandasubcutaneous
afata-


acorrectaanswera✔✔resultingainaincreasedariskaforafractures,adecreasedamobility,adifficultyaf

oraoralaintubation,ariskaofaskinainjury,aincreasedariskaforahypothermia,achallengesainarehabili
ation

FunctionalachangesainaEndocrineasystemaincludeadecreasedaproductionaandaresponseatoat
hyroxinaandadecreasedadehydroepiandrosteronea(DHEA)a-
acorrectaanswera✔✔resultingainaoccultahypothyroidism,arelativeahypercortisoneastatesaandai

ncreasedariskaofainfection

Trueaorafalse:aArthritisacanacomplicateatheaairwayaandacervicalaspine.aPatientsacanahaveam
ultileveladegenerativeachangesaaffectingadiskaspacesaandaposterioraelementsaassociateda
withasevereacentralacanalastenosis,acordacompression,aandamyelomalaciaa-
acorrectaanswera✔✔true




Inaelderlyapopulation,adueatoatheirachangesainapulmonaryasystem,aplacingaaagauzeabetwee
nagumsaandacheekatoaachieveasealawhenausingabagavalveamaskaventilationaisaokay.aInaaddit
ion,abecauseaagingacausesaaasuppressedaheartaratearesponseatoahypoxia......a-
acorrectaanswera✔✔respiratoryafailureamayapresentainsidiouslyainaolderaadults.




Agearelatedachangesainatheacardiovascularasystemaplaceatheaelderlyatraumaapatientaatasign
ificantariskaforabeingainaccuratelyacategorizedaasahemodynamicallyastable.a-
acorrectaanswera✔✔Elderlyapatientsahaveaaafixedaheartarateaandafixedacardiacaoutput,athus,a

, theiraresponseatoahypovolemiaawillainvolveaincreasingatheirasystemicavasculararesistance.a
Furthermore,asinceaolderapatientsahaveaHTN,aanaacceptableaBPamayatrulyareflectaaahypote
nsiveastate.aAasystolicaBPaofa110aisatoabeautilizedaasatheathresholdaforaidentifyingahypotensi
onainapatientsa65aandaolder.

Doanoaequateabloodapressureawithashockainaolderapatientsa-
acorrectaanswera✔✔BPainaolderapatientsamayalookanormaladueatoatheamedicationsatheyaarea

on.aUsealactateaandabaseadeficitatoaevaluateaforaevidenceaofashock

whata2afactorsaplaceaelderlyapatientsaatariskaforaintracranialahemorrhage?a-
acorrectaanswera✔✔agingacausesaduraatoabecomeamoreaadherentatoatheaskullaincreasingari

skaofainjuryaandaolderapatientsaareaonaanticoagulantaandaantiplateletamedications.

Lossaofasubcutaneousafat,anutritionaladeficiencies,achronicamedicalaconditionsaplaceaelderl
yapatientsaasariskaforahypothermiaaandacomplicationsaforaimmobility.a-
acorrectaanswera✔✔Rapidaevaluationaandawhenapossibleaearlyaliberationafromaspineaboard

saandacervicalacollarsawillaminimizeacomplications.

TrueaoraFalse:aFallapreventionaisatheamainstayaofareducingatheamortalityaassociatedawithape
lvicafractures.a-acorrectaanswera✔✔true

poorahygiene,adehydration,aoralainjury,acontusionsaaffectingatheainneraarms,ainnerathighs,ap
alms,asoles,ascalp,aear,anasalabridgeaandatempleainjuryafromabeingastruckawhileawearingagl
asses,acontactaburnsaandascalds.aTheseaareaallasignsaof.......?a-
acorrectaanswera✔✔Elderamaltreatment.aTheapresenceaofaphysicalafindingsaofamaltreatme

ntashouldapromptaaadetailedahistory.aifahistoryaconflictsawithafindings,aimmediatelyareportafin
dingsatoaauthorities.

Trueaofafalse:aearlyaactivationaofatheatraumaateamamayabearequiredaforaelderlyapatientsawho
adoanotameetatraditionalacriteriaaforaactivationa-


acorrectaanswera✔✔True.aAasimpleainjuryasuchaasaanaopenatibiaafractureainaaafrailaelderlyapa

tientamayabecomealifeathreatening.

Commonamechanismsaofainjuryaincludeafalls,aMVC,aburns,aandapenetratingainjuriesa-
acorrectaanswera✔✔commonainjuriesainatheaelderlyaincludearibafractures,aTBI,apelvicafractur

es

Theabestainitialatreatmentaforatheafetusaisatoaprovideaoptimalaresuscitationaofatheamother.aTr
ueaoraFalse?a-
acorrectaanswera✔✔True.aAlsoaifaxrayaexaminationaisaindicatedaduringatheapregnantapatient'

satreatment,aitashouldanotabeawithheldabecauseaofatheapregnancy.

Whatahappensaasatheauterusaenlargedaandatheabowelaisapushedacephalad.a-
acorrectaanswera✔✔Whenatheauterusaenlargesaitapushesatheabowelacephaladaandatheauteru

saliesainatheaupperaabdomen.aAsaaaresult,atheabowelaisasomewhataprotectedafromabluntaabd

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