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First group ATLS MCQs

1- triage concept : save more lives with available resources
2- a patient with gunshot , BP 70/0 , Chest tube drained 120 ml , chest sounds normal. next
- Laparatomy
3- persistent pneumothorax after placing chest tube. Diagnosis?
- Tracheobronchial injury
4- which of the following is not part of the initial assessment?
- determining incomplete,or complete neurological deficit
5- echomosys in prenium , blood in meatus ,what will you do?
- retrograde urethrogram
6- Class II shock:
- normal BP
7- patient with minimal trauma to chest and tenderness, ABCDE are good, how to manage?
- pain medication
8- old patient on B-blocker and Coumadin (warfarin), decreased BP, normal pulse, which of
the following is true?
- excessive fluids cause cardiopulmonary failure.
9- indication for intubation?
- maxilofacial injury
10- moderate head injury- GCS 11, what to do?
- CT scan + repeat GCS assessment
11- Neurogenic shock except: neurologic deficit
12- Neurogenic shock management: vassopressor
13- initial step in multiple injured pt: ask the patient's name
14- pt. with blunt trauma to abdomen.. Decreased BP, no external bleeding: FAST
15- DPL: most sensetive
16- unsucceful endotracheal intubation: surgical cricothyroidectomy
17- anatomy: choroid plexus produce CSF in the lateral and third ventricle..
18- failed intubation: bogie
19- unconscious baby then awake then deteriorate: epidural
20- pt fell and can't move lower limb with sensory problem: spinal shock
21- laparotomy indication: CT with retroperitoneal air
22- circumfrential burn: escharotomy
23-Pediatric: flexible mediastinum
24- sacral sparing: good prognosis
25- most common cause of acid base problem in pediatrics: ventilation
26- 80 kg male with 50% burn and received 1 L NS came after 3 hour.. What is the fluid per
hour in the next 5 hours?
1400 ml/hr
27- X-ray of ruptured aorta except: air in mediastinum

28- indication to anti-Rh in pregnant women except: gunshot wound to the foot
29- pregnant lady with PV bleeding, initial assessmentAirway..
30- difficulty in respiration, loss of sensation in the foot?
- possible cervical injury


Second group ATLS MCQs

1. Which of the following is addressed in the secondary survey? Answer: Forearm

2. A young male fallen from height with obvious flail chest. ABG shows pH of 7.47. what
is the cause of this abnormality? Answer: pulmonary contusion
3. Cushing's triad which occurs in cases ofincreased intracranial pressure? Answer:
Bradycardia with irregular respirations and isolated increase in SYSTOLIC BLOOD
4. Trauma in pregnant women, clear fluid leakage from vagina is an indication for
5. Blood at the external meatus ! do RUG
6. Scenario of pelvic fracture, which statement is correct? Answer: vertical shear force
with posterior ligaments disruption.
7. 12 year old boy sustained blunt abdominal trauma while playing football. FAST scan is
positive. He is hemodynamically stable. What to do next? Answer: CT abdomen
8. Old patient, had multiple rib fractures, splinting of the right chest, what to do?
Answer: give analgesic.
9. Memorize indications for burn transfer ( eg > mixed partial and full thickness burn
>10% of total BSA ! transfer)
10. In comparison with young adults, elderly patients exhibit which of the following
regarding brain injuries? A- increased cerebral blood flow. B- less stretching of
bridging veins C- less subdural hematomas D- less brain contusions E- les mobility with
angular acceleration and deceleration. Answer is D, less brain contusions than younger
11. Which of the following will be missed by DPL? Answer: subcapsular hematoma of the
spleen (because it is a retroperitoneal organ)
12. Which of the following tests will evaluate the retroperitonium? Answer: CT
13. Patient tried to commit suicide with a rope (hyperextension of the neck), when he
presented to ER he had hoarsness of voice and crepitation in the neck, what to do? Aneedle cricothyroidotomy B- surgical tracheostomy in OR C- direct laryngoscopy and
intubation. Answer: ????
14. Burn victim with signs of inhalation injury (carboneacous material, singed eyebrows)
! Intubate.

15. Burn victim, has circumferential burn, core temperature is 34 C. what next? Aescharatomy B- rewarm C- oxygen mask (I think the answer is C oxygen mask because
you should follow the ABCD priorities)
16. Which of the followings is NORMAL in pregnancy? A-increased residual lung volume Bdecreased plasma volume C- decreased total RBC mass D- widened symphysis pubis.
Answer is D
17. Trauma patient was hypotensive then you gave him 1 L of crystalloid and now he is
alert and talking. Which of the following statements is correct? Answer: He has good
cerebral blood flow
18. Which of the followings is a contraindication for nasal intubation? A- depressed skull
fracture B- Le Fort III fractures. Answer is B (Le Fort III fractures causes cribriform
plate fracture)
19. Which of the followings will benefit from oropharyngeal airway? A- posterior
displacement of tongue B- laryngeal edema. Answer is A
20. Patient came with severe head injury GCS is 6 and has poor anal sphincter tone and
diagrammatic breathing. His hands are flexed across the chest. What is the cause of
his injury? A-isolated head injury. B-lumbosacral verterbral injury. C- Cervical
vertebral injury. Answer is C
21. Patient with sever substernal pain. CXR shows widened mediastenum? do ECG
22. Question about spinal board? A-Remove after completing assessment B- it leads to
decubetus ulcers .. answer: ????
23. CSF is between? Arachinoid and pia matter.
24. Question about transfer? Transfer after stabilizing the patient.
25. Scenario with scalp laceration .. the priority was to stop the bleeding with direct
pressure. The other choices are all after the circulation.
26. Patient with head injury and systemic hypotension, what is the most probable cause
of his hypotension? A- bleeding in the brain B- systemic hypovolemia. Answer is B
27. Dorsal column? Carries proprioception from the same side of the body.
28. Elderly fallen from horse.. low blood pressure but normal heart rateanswer: current
medications might be involved.
29. Neurogenic shock.. answer: unlikely if injury below the level of T6.
30. Which of the followings will NOT have an effect of the clinical presentation of
hemorrhagic shock? A- gender B- age extremes C- delay in transfer Answer:???
31. Patient with stab wound to the upper abdomen. Which test to do? A- abdominal X ray
B- FAST C- barium enema D- upper GI endoscopy. Answer: B
32. Question about burn and fall from height. Answer: examine the pelvis and the long
bones for fractures.