ATLS Study Quiz 2024 Graded A+
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 people 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 truly
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 for 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 the
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 large and thin walled. In vertex
