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ITLS Exam Preparation| The Complete Exam Guide – Questions & Model Answers
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Which ventricle usually gets the myocardial contusion? Why? - Right. Because it is more anterior than the left side, as well as it can collide with the sternum. Explain the pathophysiology of cardiogenic shock - 1. Heart muscle itself is damaged 2. Pumping strength is reduced, cardiac outp...

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  • March 18, 2025
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  • 2024/2025
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ITLS Exam Preparation Questions

Which ventricle usually gets the myocardial contusion? Why? - ✔ ✔
Right. Because it is more anterior than the left side, as well as it can
collide with the sternum.

Explain the pathophysiology of cardiogenic shock - ✔ ✔ 1. Heart
muscle itself is damaged

2. Pumping strength is reduced, cardiac output falls and blood pressure
goes down.

4. Possible dysrhythmia

5. Blood backs up into the venous system, resulting in distended neck
veins.

6. Lung and peripheral perfusion drops, leading to dyspnea and
cyanosis.

7. Because the patient is in shock with an intact spinal cord,
catecholamines are released, developing tachycardia and diaphoresis

How quickly can a traumatic cardiac tamponade to a circulatory arrest
occur? - ✔ ✔ 5-10 minutes

Normal Hgb is ___ grams per 100mL. A patient has to have at least ___
grams of deoxygenated hemoglobin (Hgb) per 100mL of blood for
cyanosis to occur. Someone bleeding to death may not have enough
hemoglobin around to manifest cyanosis. - ✔ ✔ 14, 5

,Describe the management of hemorrhage that can be controlled - ✔
✔ 1. Apply direct pressure to the wound



*If unsuccessful, apply a tourniquet

What do you do when you encounter a hemorrhage that you cannot be
controlled? - ✔ ✔ Transport rapidly to the appropriate facility.

The patient with a severe head injury (Glasgow Coma Score of 8 or less)
and shock cannot tolerate _______. Therefore, if necessary, they
should be fluid resuscitated to a blood pressure of ___ mmHg systolic
to maintain a cerebral perfusion pressure of at least ___ mmHg. - ✔
✔ hypotension, 100 [also in book says 90-100], 60

Describe the four points of managing a nonhemorrhagic shock
syndrome (mechanical, cardiogenic and high-space) - ✔ ✔ 1. High-
flow oxygen

2. Rapid transport

3. supine positioning

4. IV line placement (usually en route)

Discuss the use of hemostatic agents for uncontrolled extremity
hemorrhage - ✔ ✔ If you cannot stop the bleeding with pressure or
a tourniquet, you may use a hemostatic agent (apply pressure for at
least 2 minutes). It is an "adjunct" to assist in controlling hemorrhage,
not a hemorrhage control by itself. It's part of an overall hemorrhage
control protocol.

What does "TBI" stand for? - ✔ ✔ "Traumatic Brain Injury"

,Describe six anatomical parts of the head and brain - ✔ ✔ 1. Scalp

2. Skull

3. Fibrous coverings of the brain (meninges: dura mater ["tough
mother'], arachnoid mater, pia mater ["soft mother"])

4. Brain tissue

5. Cerebrospinal fluid (found between the arachnoid and pia mater)

6. Vascular compartments

What does "CSF" stand for? - ✔ ✔ "Cerebrospinal Fluid"

What does "ICP" stand for? When is it considered dangerous? - ✔ ✔
"Intercranial Pressure", >15 mmHg

Describe the "Monro-Kellie Doctrine" - ✔ ✔ It states that the
contents of the skull (brain, blood and CSF) are at a fixed volume and a
change in volume of one is compensated by a decrease in the other
two.

The only significant opening through which the pressure in the brain
can be released is the _______ _______ at the base of the skull. - ✔
✔ foramen magnum

Explain the difference between primary and secondary brain injury - ✔
✔ Primary brain injury occurs as an immediate damage to the brain
tissue that is a direct result of an injury force, while secondary brain
injury is the result of hypoxia and/or decreased perfusion of brain
tissue after primary injury.

, Describe the 5 main mechanisms for the development of secondary
brain injury - ✔ ✔ 1. Swelling, from the primary injury, can cause a
decrease in perfusion.

2. Hypoxia or hypotension may occur insulting the brain

3. Bruising or injury of the brain results in vasodilation with increased
blood flow to the injured area

4. Since there is no extra space inside the skull, the swelling increase
intracerebral pressure which leads to a decreased cerebral blood flow
that causes further brain injury

5. This process may take hours to develop

What does "CPP" stand for? - ✔ ✔ "Cerebral Perfusion Pressure"

What does "MAP" stand for? What is it? - ✔ ✔ "Mean Arterial
Pressure". The sum of the diastolic blood pressure plus one-third of the
pulse pressure (systolic blood pressure minus the diastolic blood
pressure).

At what pressure can cerebral herniation occur? - ✔ ✔ >25 mmHg

What is "Cushing's reflex"? - ✔ ✔ A reflex in which the body
responds to markedly elevated ICP by raising both the diastolic and
systolic blood pressure, reduction of heart rate, and irregular
respiration. Also called "Cushion's response", this happens late in the
course of head injury.

What does "ARDS" stand for? - ✔ ✔ "Adult Respiratory Distress
Syndrome"

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