Deck 3: Chest Trauma

Question 1

If death occurs within three hours of a blunt chest injury, which of the following is most likely not the cause?

A)Airways obstruction
B)Multi organ system failure
C)Aortic disruption
D)Cardiac Tamponade

Answer 1

Multi organ system failure

Question 2

A 25 year old male was hit by automobile on his right side of the anterior chest wall you send the patient for X-ray of the chest you are thinking about the X-ray report to come which rib fracture you think will be dangerous and serious for in this patient ?

A)First rib
B)Third rib
C)Fifth rib
D)Seventh rib

Answer 2

First rib

Question 3

Which of the following is the most common site for tearing in a Traumatic Aortic Disruption?

A)Aortic isthmus
B)Proximal descending aorta
C)Ascending aorta
D)Aortic arch

Answer 3

Proximal descending aorta

Question 4

Which of the following signs will be present in traumatic aortic disruption patient?

A)Shock
B)Hypotension
C)Chest pain
D)All of the above

Question 5

All of the following are signs and symptoms of traumatic aortic disruption except?

A)Upper extremity pulse defects
B)Decreased pulse strength or B/P in the lower extremities compared to upper extremities
C)Decreased pulse strength or B/P in the upper extremities compared to lower extremities
D)Impaired blood flow to the lower extremities

Question 6

Which of the following are complications of a pulmonary contusion?

A)Impaired oxygenation
B)Pneumonia
C)Acute respiratory distress syndrome ( ARDS )
D)All of the above

Question 7

A 30 year old driver was brought to the emergency department he has undergone automobile accident and his car steering hit his chest causing blunt trauma of the chest the patient was hypoxic having chest pain and coughing of blood and cyanosed . You suspect pulmonary contusions which one of the following investigation will confirm the diagnosis of pulmonary contusion?

A)MRI of the chest
B)Chest X-Ray
C)CT of the chest
D)Chest ultrasound

Question 8

A 40 year old hypoxic and cyanosed patient having blunt chest trauma is brought to emergency department of the hospital you confirmed pulmonary contusions on chest radiography you start managing this patient which one of the following is given with care in management of patient having pulmonary contusion ?

A)Mechanical ventilation
B)Fluid replacement
C)Supportive therapy
D)None of these

Question 9

Which of the following is a complication in a patient that has experienced blunt force trauma?

A)Hypotension
B)Cardiac shock
C)Arrhythmias
D)All of the above

Question 10

Which of the following is not a symptom of blunt cardiac injury?

A)Heart failure ( shortness of breath )
B)High Blood pressure
C)Low Blood pressure
D)Cardiac arrhythmias

Question 11

In the management of patient with hemothorax chest tube is inserted through chest wall for?

A)To drain the blood
B)To drain the air
C)To re expand the lungs
D)All of the above

Question 12

A 36 year old male was brought to the emergency department with history of fall from the roof the chest of the patient was traumatized you suspect Hemothorax . On the basis of which one of the following signs you are suspecting this diagnosis?

A)Chest pain
B)Rapid heart rate
C)Shortness of breath
D)All of these

Question 13

A 40 year old patient with history of chest trauma was brought to the emergency department of the hospital the patient was having chest pain and dyspnea you suspect pneumothorax and you start management of this patient In the management of traumatic pneumothorax patient if mechanical ventilation is required then why it is mandatory to insert chest tube?

A)Because of the risk of pulmonary edema
B)Because of the risk of cardiac arrhythmias
C)Because of the risk of tension pneumothorax
D)Because of the risk of acute respiratory distress syndrome

Question 14

A 22 year old female has been shoot at chest her heart rate is 60 blood pressure is 70/40 respiratory rate is 23 oxygen saturation is 99% and you started her ATLS examination her airway is in midline and patent and breathing is clear on the left and on the right side breath sounds are decreased on palpation bilateral radial wrist pulses are weak on removing the patient undergarment and you noted a gunshot wound to the right parasternal area now you are doing needle decompression of the chest where you will do it ?

A)In between the 1st and 3rdintercostals.
B)In between the 2nd and 3rdintercostals line.
C)1st or 2ndintercostals space anterior to mid-axillary line
D)5th or 6th intercostals space posterior to mid-axillary line

Question 15

Which one of the following is not included in the Beck triad for diagnosis of cardiac tamponade?

A)Hypotension
B)Muffled heart sounds
C)Hypertension
D)Distended Neck Veins

Question 16

Which of the following are included in the management of cardiac tamponade patient?

A)Airway management and ventilation
B)Rapid transport for pericardiocentesis
C)Refer to ILCOR Consensus for treatment
D)All of these

Question 17

A 25 year old was brought to the emergency department with trauma to the chest think that ribs are fractured which will be confirmed on X-ray . In Ribs fracture which part Ribs are most commonly fractured

A)Head of the rib
B)Neck of the rib
C)Body of shaft of the rib
D)Posterior angle

Question 18

A 40 year old male was brought to the hospital who had rescued from automobile accident the patient has multiple ribs fractured you have not seen his X-Ray yet based on your knowledge which rib among the following is least prone to fracture ?

A)1th Rib
B)4th Rib
C)6th Rib
D)8th Rib

Question 19

In the management of patient with rib fracture all of the following are done except?

A)Restricting activities
B)Taking pain killers
C)Application of wide strips of adhesive plaster directly to the skin of the chest for immobilization
D)All of these

Question 20

Which one of the following is correct regarding flail chest?

A)it results from multiple rib fractures at multiple places
B)it is segment of the chest wall moves in the opposite direction to the rest of the chest wall
C)Two of the symptoms of flail chest are chest pain and shortness of breath.
D)All of the above

Question 21

A 30 year old man in road traffic accident received multiple injuries on the chest. Which of the following are most flail chest injuries found?

A)Falling
B)Blunt force trauma
C)Vehicle collisions
D)Rollover and crushing injurie

Question 22

A man with injuries on chest was brought to emergency department. In the management of patient with flail chest which one of the following is necessary?

A)Analgesics
B)Giving humidified oxygen via oxygen mask
C)Mechanical ventilation
D)All of these

Question 23

You respond to a 25 year male athlete, who received a non penetrating blow to chest. Following the blow, he is now unresponsive, pulseless, apneic and has no audible heart sound. What is the most likely diagnosis?

A)Myocardial infarction
B)Commotio cordis
C)Shock
D)Hypertrophic cardiomyopathies.

Question 24

The most common cause of death in commotion cordis is?

A)Atrial flutter
B)Ventricular fibrillation
C)Hemorrhages
D)Heart block

Question 25

A patient received trauma on the heart. What is initial lifesaving procedure before reaching hospital in management of patient?

A)Medication
B)Defibrillation
C)Cardiopulmonary resuscitation (CPR)
D)Precordial thump

Question 26

A man after car accident with dyspnea , impaired speech and respiratory distress with no blood on examination his neck was hyperextend, what is most likely cause of symptoms?

A)Foreign body in neck
B)Tracheobronchial trauma
C)Commotio cordis
D)Impaired conscious level.

Question 27

A child fall from the roof of a house on examination there was diaphragmatic rupture on what characteristics feature will not develop after the trauma?

A)Hypoxemia
B)Diaphragmatic hernia
C)Hypertension
D)Low cardiac output

Question 28

Which of the following is most common cause diaphragmatic rupture?

A)Physical trauma
B)Chemical injury
C)Excessive coughing
D)Any other morbid condition

Question 29

A patient with diaphragmatic rupture was admitted to the hospital. 2 days later After initial management death occurred what was the cause of early death in diaphragmatic rupture patient?

A)Bowel obstruction
B)Lung complications
C)Diaphragmatic hernia
D)Heart complications

Question 30

After trauma a patient developed Perte's syndrome or traumatic asphyxia which of the following sign symptom is not associated with this injury?

A)Craniocervical cyanosis,
B)subconjunctival hemorrhage,
C)Facial edema
D)Hyperventilation

Question 31

A man was brought to emergency department with traumatic asphyxia. The following is not included in initial Management of traumatic asphyxia?

A)Measurement of arterial blood gases,
B)oxygen supplementation,
C)intubation with mechanical ventilation
D)Measurement of glucose level.

Question 32

Trauma to a child's chest is considered different anatomically from adult due to all of following conditions, except?

A)smaller body mass and greater forces applied per unit area
B)less fat,
C)less elastic connective tissue
D)child chest Anatomy.

Question 33

Which of the following is serious and most common injury in child trauma?

A)Chest wall trauma
B)CNS trauma
C)Lower limbs trauma
D)All of the above