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WorksheetsTintinalli Club
Total questions: 10
Worksheet time: 16mins
Name
Class
Date
1.
True or false? In penetrating injury to the chest, stab wounds are more likely to cause cardiac tamponade than gunshot wounds?
a)
True
b)
False
2.
A 15 year old male is playing in the outfield for his baseball team. The opposing team is up at bat and hits a ball into the outfield. As the patient runs to catch the ball, the sun blinds him and he misses it. The ball hits him in the chest and he falls down to the ground. The patient is pulseless. What happened?
a)
The patient suffered a myocardial infarction.
b)
The patient went into a fatal arrhythmia.
c)
The patient died from an underlying undiagnosed heart condition.
d)
The patient suffered from a massive PE.
3.
All of the following are appropriate candidates for ED thoracotomy except
a)
20 y/o M who was found down, pulseless after being hit by a car.
b)
35 y/o M who was found outside of a bar, on the ground after being stabbed in the chest during an altercation. Thready pulse on arrival to the ED. During the secondary survey, patient loses pulses.
c)
18 y/o F who presented to the ED via EMS after being stabbed in the chest by her sister after she found her cheating with her boyfriend. Patient’s initial vital signs were 70/40, 130, 12, 99% NRB. Upon transfer to the trauma stretcher, patient lost pulses.
d)
25 y/o M who arrived to the ED via EMS with CPR in progress. Patient has 3 bullet holes to the chest. He lost pulses in the ambulance on the way over to the ED.
4.
A 34 y/o M presents by ambulance following a high speed motor vehicle crash. Paramedics report that he was the unrestrained driver and there was a large amount of steering column damage. They found him in the vehicle with altered mental status and the odor of alcohol on his breath. VS include BP 150/100, P120, RR22,O2 sat 98%. He will not follow commands. There is significant facial and chest wall trauma. Auscultation of the chest reveals equal breath sounds and a loud systolic murmur. Pedal pulses are diminished. What life-threatening traumatic injury is most consistent with this presentation?
a)
Cardiac Tamponade
b)
Severe pulmonary contusion
c)
Tension pneumothorax
d)
Traumatic aortic dissection
5.
A 27-year-old man presents by ambulance after a high-speed head-on collision in which he was an unrestrained driver. On arrival, he has decreased breath sounds on the left side and is in severe respiratory distress. A chest xray reveals abdominal contents in the thoracic cavity.
Which of the following statements about this patient’s injury is correct?
Which of the following statements about this patient’s injury is correct?
a)
Blunt trauma typically produces smaller tears than penetrating trauma.
b)
It occurs most commonly on the right side of the body.
c)
Mortality rate is higher when the injury is due to penetrating trauma.
d)
Symptoms are related to the degree of herniation of abdominal contents.
6.
What is the most common visceral organ injured in blunt trauma in pediatrics and adults?
a)
Liver
b)
Spleen
c)
Pancreas
d)
Duodenum
7.
4. A 24-year-old man presents after being struck on the left side by a pickup truck while crossing a street. Initial vital signs are blood pressure 130/78, pulse rate 110, and respiratory rate 18. He is alert and oriented and had no loss of consciousness at the scene. Paramedics have established two large-bore peripheral lines and are infusing normal saline; he has received less than 500 mL on arrival. Abdominal examination reveals tenderness in the left upper quadrant and suprapubic region. Plain radiographs reveal a pelvic fracture. What would be the best diagnostic test in this scenario to definitively diagnose the etiology of the patient’s abdominal pain?
a)
Abdominal CT
b)
DPL
c)
Exploratory Laparotomy
d)
FAST exam
8.
The focused assessment with sonography in trauma (FAST) scan of a patient with blunt abdominal trauma shows a hypoechoic stripe in the pouch of Douglas. Which of the following is correct?
a)
There is at least 50mL of free fluid in the abdomen.
b)
This indicates a ruptured bladder.
c)
In the presence of hemodynamic instability, this indicates need for a laparotomy.
d)
The patient requires repeat abdominal exams and FAST examinations in the ED.
9.
A 67-year-old female who is taking Coumadin for atrial fibrillation presents after a high-mechanism motor vehicle collision. Her heart rate is 142 beats per minute and blood pressure is 84/40 after 1 L of normal saline. Her GCS is 6, and her left pupil is 6 mm versus 3 mm on the right. Her physical examination is notable for a seat belt sign on the abdomen. Which of the following IS NOT an acceptable approach to her initial assessment and treatment?
a)
Perform endotracheal intubation and mild hyperventilation.
b)
Perform chest and pelvic radiographs in the trauma bay.
c)
Proceed to radiology for an emergent abdominal CT scan.
d)
Perform a FAST exam to evaluate for the presence of intra abdominal fluid.
10.
A 37-year-old man presents with chest pain after a MVC. He states that his chest hit the steering wheel. On initial evaluation, the patient is without fractures of the ribs or sternum, but there is a small chest wall contusion. The initial chest radiograph is negative, and the electrocardiogram shows nonspecific ST-T wave changes. What is the next step in the emergency management of this patient?
a)
Discharge home after repeat EKG in 1 hour.
b)
Discharge home after repeat EKG and troponin at 6 hours.
c)
Discharge home if initial troponin is negative.
d)
Admit to Tele for 23 hr observation.
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