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ATLS EXAM Questions and Answers |
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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.
✓ True
In the elderly population, what is decreased physiological reserve?
✓ 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:
✓ cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly?
✓ 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?
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✓ 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?
✓ 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
✓ 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.
✓ 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?
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✓ 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?
✓ 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)
✓ 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
✓ 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
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✓ resulting in drug dosing for renal insufficiency, decreased ability to
concentrate urine, increased risk for AKI and urine f low 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
✓ 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)
✓ 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
✓ true
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