ETM Pre-Course MCQ

ETM Pre-Course MCQ

Please complete the MCQ prior to the first day of the course.
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1. Which staff members are included in a “trauma team”?*

ED Medical staffED Nursing StaffRadiographerSurgeonAll of the above
2. The ATMIST handover includes all of the following EXCEPT:*

Patient ageMechanism of injuryThe patient’s past medical historyThe time of injuryVital signs
3. Regarding the initial assessment all of the following are true EXCEPT:*

Airway assessment includes inspection of the mouth/oral cavity for blood, vomit, secretions, loose teeth or foreign bodiesBandages and dressings applied pre-hospital must not be removed in EDTourniquets may be removed in ED if the wound is small and haemorrhage can be controlled with direct pressureClinical signs of cardiac tamponade are neither sensitive nor specificThe goal of circulation assessment and management is to find the bleeding, stop the bleeding and correct deficiencies
4. Which of the following regarding circulation assessment is TRUE:*

Capillary refill time is a reliable indicator of shockHypotension and tachycardia always indicate that shock is presentLarge volume blood loss may occur into the retroperitoneal spaceAn adult femur fracture may lose up to 500ml of blood into the thighThe FAST scan can reliably exclude all intra-abdominal haemorrhages
5. In a patient arriving in the ED with obvious signs of haemorrhagic shock, the initial resuscitation fluid of choice is:*

A 1:1:1 ratio of red blood cells - plasma - platelets0.9% (Normal) SalineHartmann’s solution (Lactated Ringers3% Saline5% Glucose
6. In a patient with a penetrating neck wound, hard signs of vascular injury include all of the following EXCEPT:*

Active haemorrhage from the woundLarge, pulsatile haematomaHaemoptysisShockAltered conscious state
7. In traumatic cardiac arrest, after the airway has been secured, which is the next most important procedure to be carried out?*

CPRBilateral finger thoracostomiesAdministration of 2 litres of 0.9% normal salineThoracotomyAdministration of adrenaline
8. With regard to traumatic tension pneumothorax, which of the following is TRUE:*

Needle decompression is a reliable method for decompressionChest X-ray is essential for diagnosisIntravenous access for analgesia should be obtained prior to decompressionFinger thoracostomy is the preferred method for decompressionThe aim of treatment is rapid insertion of an intercostal catheter
9. Regarding pericardial tamponade, which is FALSE:*

In the arrested patient, the preferred drainage method is emergency resuscitative thoracotomyClinical signs of tamponade are more sensitive than ultrasoundRight ventricular injury is more common than left ventricular injury due to anatomic locationAs little as 100ml of blood can cause tamponade in an adultChest x-ray cannot exclude the diagnosis
10. Regarding shock, which is TRUE:*

Tension pneumothorax may cause distributive shockCardiogenic shock is caused by pericardial tamponadeClinical assessment of shock is highly accurateNeurogenic shock should be suspected in the patient with hypotension and relative bradycardiaShock in elderly patients presents the same as in younger patients
11. Sites of concealed blood loss that may result in hypovolaemic shock include all of the following EXCEPT:*

IntracranialIntrathoracicIntra-abdominalRetroperitonealThigh (with femur fracture)
12. Regarding traumatic brain injury:*

A contre-coup injury occurs on the same side as the initial impactExtradural haemorrhage is the most common type of intracranial bleedingA GCS of 12 is consistent with a minor head injuryA dilated pupil in a patient with a head injury is always due to underlying brain injurySubdural haemorrhage is the most common type of intracranial bleeding
13. Airway management in trauma may include all of the following EXCEPT:*

Use of airway adjuncts such as oropharyngeal airwaysUse of suction to clear debris from the pharynxApplication of non-invasive ventilation (CPAP/BiPAP) for supine patients in spinal precautionsRapid sequence intubationUse of supraglottic airway devices such as a Laryngeal Mask Airway
14. Regarding spinal trauma:*

Less than 1% of patients with a spinal fracture will have a second spinal fractureNeurogenic shock is due to loss of sympathetic autonomic outflow and classically results in hypotension and relative bradycardiaThe NEXUS criteria are 100% sensitive for ruling out cervical spine injuryPressure ulcers rarely occur in patients left in spinal immobilisation for long periods of timePlain x-rays can reliably exclude cervical spine fractures in adults
15. In haemodynamically stable patients with blunt abdominal trauma:*

Abdominal palpation is reliable in predicting potential underlying injuriesA digital rectal examination is reliable for excluding colonic injuryCT scan has a high negative predictive value for ruling out intra-abdominal injuriesSeatbelt bruising across the lower abdomen implies superficial injury onlyFAST scans should only be performed if the patient becomes unstable
16. Regarding pelvic fracture:*

Pelvic fractures are strongly associated with other potentially life threatening injuries in other body regionsThe majority of bleeding in pelvic fractures is arterial in originAbsence of blood at the urethral meatus excludes urethral injurySacral fractures are rarely associated with neurologic injuryApplication of an external pelvic binder is contraindicated in patients being sent for angiography
17. During the initial assessment of a major trauma patient:*

The traditional linear A-B-C-D-E approach must be strictly followed by everyone on the trauma teamTask specific role allocation allows for better team functioningPatients should not be fully exposed prior to CT imagingThe team leader should stand at the head of the bedA patient with a GCS of 8 or less must be immediately intubated, prior to completing the initial assessment
18. Regarding mechanism of injury:*

Kinetic energy is directly proportional to velocityA person ejected from a vehicle is at low risk of injuryFalls from standing height are not associated with significant injury in elderly patientsSeatbelt bruising to the chest indicates significant deceleration forceSeatbelts increase the risk of injury in motor vehicle crashes
19. Elderly trauma patients:*

Present many diagnostic challenges due to co-morbidities and medication effectsCan routinely be safely discharged at night if only minor injuries are detectedAre more likely to develop an extra-dural than a subdural bleed in cases of head injuryDo not require dose adjustment of anaesthetic drugs if intubation is requiredAre less prone to complications from traumatic injury than younger patients
20. Regarding thoracic trauma:*

Tracheal deviation is a reliable sign of pneumothoraxAbsence of lung sliding on ultrasound can only be caused by pneumothoraxTension pneumothorax and pericardial tamponade are the two main causes of obstructive shock in traumaTraumatic aortic injury can be excluded on chest x-rayAn intercostal catheter does not need to be inserted once a tension pneumothorax has been relieved by needle decompression
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