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MRSC5014 -Trauma

Total questions: 28

Worksheet time: 15mins

Name
Class
Date
1.

Trauma Radiography - Best Practice

True or false

Currently, there is no available evidence suggesting the use of MRI in the setting of acute trauma. 

a)

TRUE

b)

FALSE

2.

Which finding during the “D” assessment most strongly suggests increased intracranial pressure?

a)

Unequal pupils

b)

Normal blood pressure

c)

Regular breathing

d)

Warm, dry skin

3.

Pelvic X-rays in trauma can be omitted if FAST is negative.

a)

True

b)

False

4.

Trauma Radiography - Best Practice

True or false

A c-spine collar must never be removed, but pelvic binders can be removed provided you have another radiographer present to assist.

a)

TRUE

b)

FALSE

5.

Trauma Radiography - Best Practice

The E-FAST Scan is used for what?

a)

To visualise free fluid in the body and pneumothorax in the anterior pleura

b)

To assess the mechanical instability of the pelvis

c)

To identify foreign bodies in the abdomen and pelvic locations

d)

As a substitute to whole body CT as it is more sensitive and specific. 

6.

Trauma Radiography - Best Practice

The Advanced Trauma Life Support (ATLS) guidelines recommend a rapid primary clinical survey of the ABCDEs and a trauma series of plain radiographs + focused assessment with sonography in trauma US.

What are the plain radiographs recommended and why?

a)

Chest XR - detecting major pneumothorax and major haemothorax

b)

Abdomen XR - to rule out any free fluid or air

c)

Pelvic XR - concern for occult pelvic injury or mechanically unstable pelvis

d)

Lateral C-spine XR - rule out atlanto-occipital dislocation or other severely displaced c-spine fracture

7.

In a hemodynamically unstable trauma patient with a positive FAST, the next step is usually: 

a)

DMSA renal scan

b)

MRI of the abdomen 

c)

Exploratory laparotomy 

d)

Whole-body CT scan

8.

When a patient utters incomprehensible sounds without forming words, what verbal score is assigned on the Glasgow Coma Scale?

a)

1

b)

2

c)

3

d)

4

9.

What do each of the letters stand for in ABCDE?

a)

Ambulant, Breathing & ventilation, Circulation, Defibrillator, External Assistance

b)

Airway, Breathing & ventilation, Circulation & haemorrhage control, Disability/Deficit, Environment

c)

Airway, Breathing & ventilation, Consciousness level, Danger, Environment

d)

Airway, Breathing & ventilation, Cervical spine clearance, Disability/Deficit, Environment

10.

Under the “C” (Circulation & Haemorrhage Control) step, which finding is not a direct sign of hypovolemic shock?

a)

Hyperthermia

b)

Delayed capillary refill 

c)

Hypotension 

d)

Tachycardia 

11.

The “E” (Exposure & Environmental Control) step includes all the following except:

a)

Removing clothing to inspect for hidden injuries 

b)

Maintaining normothermia with warming blankets 

c)

Protecting patient dignity with appropriate covering

d)

Full immobilisation of limbs 

12.

In the “D” (Disability) evaluation, which GCS score necessitates immediate airway protection?

a)

12

b)

9

c)

8

d)

15

13.

A patient flexes their arm withdraws from painful stimuli. What motor response score does this represent on the Glasgow Coma Scale?

a)

3

b)

4

c)

5

d)

6

14.

Which of the following correctly identifies the non‐contrast components of a whole‐body CT (WBCT) trauma protocol in a stabilised patient?

a)

CT C‐spine and CT Head 

b)

CT Chest (arterial phase) and AbdoPelvis (portal venous phase) 

c)

CT C‐spine and CT Chest (arterial phase) 

d)

CT Head and AbdoPelvis (portal venous phase)

15.

Which type of blast injury is caused by missiles or debris propelled by the explosion?

a)

Primary

b)

Secondary

c)

Tertiary

d)

Quaternary

16.

Trauma is best defined as a sudden, unexpected, dramatic event that results in injury. Which element is not part of this definition?

a)

Sudden onset

b)

Anticipated event

c)

Forceful impact

d)

Potential long-term disability

17.

Chemical burns fall under which trauma category?

a)

Blunt force

b)

Penetrating

c)

Explosive

d)

Thermal

18.

When adapting a foot X-ray for a supine trauma patient, the tube should be angled:

a)

Steep cranially to foreshorten metatarsals

b)

Always at 45° caudally

c)

Perpendicular to the sole of the foot

d)

In line with the tibial shaft

19.

For AP tibia/fibula in a supine patient with limited rotation, the best adaptation is:

a)

Use ultrasound instead

b)

Traditional PA projection

c)

Angle the beam

d)

Medial-lateral projection only

20.

In mass-casualty scenarios, FAST is especially useful as a:

a)

Replacement for CT scanning

b)

Triage tool to identify unstable patients

c)

Method to evaluate cortical scarring

d)

Definitive diagnostic tool

21.

According to best-practice guidelines, image quality in trauma radiography:

a)

Is the sole responsibility of the radiologist

b)

Can be compromised if the patient is unstable

c)

Should never be sacrificed for speed

d)

Is secondary to radiation dose reduction

22.

A 52-year-old male motorcyclist is brought into the resuscitation bay after a high-speed collision. He’s hypotensive (BP 85/50), tachycardic, and has a distended, tender abdomen. His C-spine is immobilised and he remains supine on the trolley. A FAST exam is positive.

Which is the most appropriate next step in imaging management?

a)

Pelvic binder removal and repeat FAST

b)

Whole-body CT trauma series with IV contrast

c)

Direct transfer to operating theatre for laparotomy

d)

Supine AP chest X-ray then pelvic X-ray

23.

A 28-year-old construction worker falls from scaffolding. He’s alert, haemodynamically stable, but complains of neck pain. He remains in his cervical collar and cannot extend his neck. You need a lateral C-spine view.

Which radiographic adaptation is most suitable?

a)

Standard lateral C-spine in erect position

b)

AP supine C-spine with increased tube angle

c)

Horizontal beam lateral (HBL) C-spine on trolley

d)

Odontoid peg view with the collar removed

24.

A 65-year-old woman presents after a simple trip-and-fall at home. She has pain and swelling in her left mid-foot. She cannot dorsiflex her ankle or flex her knee.

To assess for a Lisfranc injury, which approach yields the most diagnostic foot series?

a)

AP/oblique/medial-lateral foot in seated position

b)

AP and lateral foot (HBL) with beam angled to arch

c)

45° plantarflexed AP foot plus standard lateral

d)

Tunnel view (plantodorsal) without modification

25.

A 40-year-old intubated patient with suspected pneumothorax arrives from the field. He remains supine, and portable CXR is requested.

What marker and view combination should be used to ensure proper interpretation?

a)

“AP” marker on upright PA chest

b)

“Supine” marker on AP supine CXR

c)

“HBL” marker on horizontal beam lateral CXR

d)

“Erect” marker on semi-erect AP CXR

26.

A 50-year-old male arrives with pelvic pain after a crush injury. He's hypotensive; pelvic binder is in place. Portable AP pelvis shows an “open-book” pattern.

What is the most critical next imaging decision?

a)

Remove binder and obtain AP pelvis off the trolley

b)

Proceed directly to the operating room for stabilization

c)

Order contrast-enhanced CT abdomen/pelvis before surgery

d)

Perform an E-FAST study to look for intra-abdominal fluid

27.

A 17-year-old with a GCS of 6 following a skateboard accident presents with unequal pupils and hypotension. He’s intubated and has cervical immobilisation.

Which imaging pathway aligns with ATLS and local trauma protocols?

a)

Immediate WBCT series (head to pelvis)

b)

Plain films only—lateral C-spine, chest, pelvis

c)

FAST exam then MRI head if negative

d)

Skull X-ray followed by lumbar spine CT

28.

A hemodynamically stable 45-year-old has multiple facial lacerations after an assault. He complains of jaw pain and mild malocclusion.

Which imaging strategy is most appropriate to assess suspected mandibular fractures?

a)

Panoramic dental film alone

b)

CT maxillofacial series with 3D reconstructions

c)

AP and lateral skull X-rays only

d)

Oblique mandible projections on mobile machine