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ATLS EXAM QUESTIONS AND ANSWERS 2024True 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 Answers ✔✔ -True
In the elderly population, what is decreased physiological reserve? -
correct Answers ✔✔ -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 Answers ✔✔ -cirrhosis, coagulopathy, COPD, ischemic heart
disease, DM
What is the most common mechanism of injury in the elderly? - correct
Answers ✔✔ -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 Answers
✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -
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
Answers ✔✔ -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 Answers ✔✔ -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 Answers
✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -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
Answers ✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -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 Answers ✔✔ -Elder maltreatment. The
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