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ATLS Written Review EXAM QUESTIONS AND ANSWERS 100 % PASS A+ GRADE
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ATLS Written Review EXAM QUESTIONS AND ANSWERS 100 % PASS A+ GRADE
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ATLS Written Review EXAM 2024-2025 QUESTIONS AND ANSWERS 100 % PASSA+ GRADE
What is the preferred PaCO2 in brain injury? - answer>>35 mm Hg
What is the primary goal of treating TBI? How is this done? - answer>>preventing
secondary brain injury. This is done by maintaining blood pressure and providing
adequate profusion.
How long after discharge should patient with mild brain injury be observed by
friend? - answer>>24 hours
What type of brain injury requires serial GCS? - answer>>ALL. minor. moderate.
major
What imaging is done in all patient with moderate brain injury? - answer>>CT
What factor of ABCDE must be monitored closely in moderate brain injury? -
answer>>Airway and breathing. rapid deterioration may occur. hypoventilation
and hypercapnia may ensue requiring intubation. close monitoring in ICU is
required.
What should immediately follow the secondary survey in major/severe brain
injury? - answer>>CT.
REMEMBER: CT should never delay patient transfer
,When assessing ABCDE of severe brain injury, when does DPL or FAST come
before neuro exam? - answer>>if the systolic blood pressure cannot be brought
above 100, DPL or FAST is done first as to assess source of hypotension
Spinal cord injury has what result in blood pressure? - answer>>hypotension. This
may also occur in terminal brain injury with medullary failure
What needs to be cleared before Doll's eye testing is conducted? -
answer>>cervical spine must cleared.
What tests should be performed before sedation? - answer>>GCS and pupillary
rxn
A midline shift of _____mm or greater on the CT is indicative of need for
neurosurgery to evacuate the clot or contusion causing the shift - answer>>5mm
What type of fluids should be used? - answer>>hypertonic (ringers lactate or
normal saline). NO GLUCOSE.
What electrolyte abnormality is associated with brain edema and must be
monitored? - answer>>hyponatremia
What are the physiologic consequences of PaCO2 >45?
PaCO2 <30? - answer>>f PaCO2 >45 = vasodilation = inc ICP
, PaCO2 <30 (hyperventilation) = constriction = ischemia
If ICP is rapidly increasing, what can be done while preparing for craniotomy? -
answer>>hyperventilation. NOTE: this must be monitored closely and is only done
very short periods at a time
Does hypertonic saline lower ICP in hypovolemia?
Does mannitol lower ICP in hypovolemia? - answer>>No
NO
After administration of mannitol what should be monitored closely? -
answer>>ICP! mannitol has a substantial rebound effect on ICP
What is the role of muscle relaxants (vecuronium or succinylcholine) in seizures
with TBI? - answer>>NONE.
these may mask tonic-clonic seizures and prevent anticonvulsant intervention
(30-60 min of seizure = secondary brain injury)
What meningeal tear would a CSF leakage of a head laceration indicate? -
answer>>dural tear
What is the treatment of any intracranial mass lesion? - answer>>Must be
evacuated by neurosurgeon. transfer if not available.
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