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ATLS Written Review QUESTIONS AND ANSWERS A+ GRADED 100% VERIFIED 2025/2026
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ATLS Written Review QUESTIONS AND ANSWERS A+ GRADED 100% VERIFIED 2025/2026
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ATLS Written Review1. _______ fills the space between the arachnoid and pia mater? - ANS-CSF. this
cushions the brain and spinal cord.
2. A GCS of ___ is accepted definition of coma? - ANS-8 or less
3. A local area of frost bite should be rewarmed with what temperature and in what
waY? - ANS-40C (104F)
4. should be done in whirlpool. not dry heat.
5. 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 - ANS-5mm
6. After administration of mannitol what should be monitored closely? - ANS-ICP!
mannitol has a substantial rebound effect on ICP
7. After managing ABCDEs of TBI what MUST be identified if present? How is this
done? - ANS-mass lesion that requires surgical evacuation is critical! this is done
with CT. NOTE: obtaining a CT should not delay patient transfer to trauma center.
8. An 18-year-old man is brought to the hospital after smashing his motorcycle into a
tree. He is conscious us and alert, but paralyzed in both arms and legs. His skin is
pale and cold. He complains of thirst and difficulty in breathing. His airway is clear.
His blood pressure is 60/40 and his pulse rate is 140 beats per minute. Breath
sounds are full and equal bilaterally. He should be treated for what first? -
ANS-hypovolemic shock with fluids.
9. NOTE: airway is OK because he is talking even though he complains of trouble
breathing.
10. At what age do cervical spine differences begin to normalize? at what age does
cervical spine look like that of an adult? - ANS-marked differences in cervical spine
occur until age 8 and steadily decline until age 12 when they are similar
11. At what levels do the spinal cord begin and end? - ANS-begins at foramen magnum
at terminal end of the medulla oblongata and end at L1
12. average ICP is _____ mmHg. - ANS-10
13. Basilar fractures of the skull usually require what type of imaging? - ANS-this
requires CT with bone-window setting.
14. Carboxyhemoglobin levels greater than ___% in burn patient indicate inhalation
injury and require transport and/or intubation if transport is prolonged. - ANS-10%
15. Chest tube is indicated for which of the following?
16. -tension pneumo
17. -hemothorax
18. -ruptured bronchus
19. -pulmonary contusion
20. -mass hemothorax - ANS-All EXCEPT pulmonary contusion
21. Compare the specificity and sensitivity of DPL and CT in blunt abdominal trauma. -
ANS-DPL- high sens (98), low spec
22. CT - high sens (92-98), high spec (95)
23. Contusion occur in ___% of TBI. They often occur in _____ or ______ lobes of brain.
They may coalesce to form ______ in as many as 20$%. - ANS-20-30%
, 24. frontal or temporal
25. intracerebral hematoma.
26. Does hypertonic saline lower ICP in hypovolemia?
27. Does mannitol lower ICP in hypovolemia? - ANS-No
28. NO
29. does weakness occur on the same or opposite side of the uncal herniation? -
ANS-OPPOSITE. the corticospinal tract of the midbrain is compressed and then
crosses at the foramen magnum.
30. Epidural hematomas often occur in the _____ area of the skull and result from a tear
of the _______ arteries. - ANS-temporal
31. middle meningeal artery
32. Fluid resuscitation of an infant begins with _______(amount and type). And then
progresses to ______. (amount and type) - ANS-20mL/kg Ringers lactate.
33. (may give up to three of these boluses initially)
34. For the third bolus consider PRBCs at 10mL/kg
35. For a patient bleed profusely from a wound not he medial thigh where should
pressure be applied? - ANS-pressure should b applied directly to the wound. Do not
apply pressure to the proximal femoral artery at the groin
36. For a patient who is not breathing what intervention is indicated? - ANS-orotracheal
intubation
37. for a penetrating object such as an arrow or screw driver into the skull, test should be
performed and what should be done with the object? - ANS-need CT, Xray for
trajectory, and angiography. leave the object in place. Removing the object lead to
fatal vascular injury.
38. For a trauma patient that requires a chest tube, the tube is placed and 1600mL of
blood returns. What is the next step in management? - ANS-prepare for exploratory
thoracotomy
39. How can one determine the appropriate tube depth for pediatric intubation? -
ANS-ETT tube size x 3
40. Ex: 4.0 ETT would be properly positioned at 12 cm from the gums
41. How do you assess a GCS of someone with asymmetric responses? - ANS-Use the
best possible because this will be the best predictor of outcome
42. How long after discharge should patient with mild brain injury be observed by friend?
- ANS-24 hours
43. If ICP is rapidly increasing, what can be done while preparing for craniotomy? -
ANS-hyperventilation. NOTE: this must be monitored closely and is only done very
short periods at a time
44. In a severe trauma where facial anatomy is distorted and an ETT cannot be placed,
what is the next step to provide ventilation? - ANS-Next would be a transchricothyroid
needle-jet insufflation. this is attached to high pressure oxygen, but can only be
provided for around 30-45min due to CO2 accumulation.
45. -the definitive after this would be a surgical chricothyroidotomy or an emergent
tracheotomy. (emergent tracheotomy is not preferred because complication and time
consuming)
46. In a subdural hematoma, what is the cause? - ANS-injury to bridging veins that
extend from brain surface to the sinuses within the dura.
47. In pediatrics: once past the glottic opening, the ETT should be positioned __ to ___
cm below the level of the vocal cords and then carefully secured. - ANS-2-3 cm
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