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Question 1
An expanding hematoma or subcutaneous emphysema in the neck after trauma is most concerning as a sign of what?
- Carotid artery dissection
- Impending loss of the airway
- Cervical spine fracture
- Laryngeal fracture
Question 2
An unconscious trauma patient with a GCS score of 8 or less needs a definitive airway.
- True
- False
Question 3
Which airway technique is specifically required when subcutaneous emphysema is present in the neck?
- Orotracheal intubation with direct laryngoscopy
- Fiberoptic nasotracheal bronchoscopy
- Emergency cricothyroidotomy
- Blind nasotracheal intubation
Question 4
Cricothyroidotomy is relatively contraindicated in children younger than ___ years.
Fill in the blank
Question 5
Which statement best compares pericardial tamponade and tension pneumothorax?
- Both have low CVP, but only tamponade causes respiratory distress
- Both have high CVP, but pericardial tamponade does not cause respiratory distress
- Pericardial tamponade causes high CVP; tension pneumothorax causes low CVP
- Pericardial tamponade causes low CVP; tension pneumothorax causes high CVP
Question 6
What is the initial fluid used for volume replacement in hemorrhagic shock?
- 2 L of normal saline
- 2 L of lactated Ringer's solution without dextrose
- Fresh frozen plasma
- Immediate packed red blood cells
Question 7
In cardiogenic shock, central venous pressure is low, so aggressive fluid resuscitation is indicated.
- True
- False
Question 8
Which clinical picture best fits vasomotor (distributive) shock?
- Flushed, pink, and warm skin with high CVP
- Pale, cold, and sweaty skin with high CVP
- Flushed, pink, warm skin, circulatory collapse, and low CVP
- Cyanotic extremities with normal CVP
Question 9
What is the first diagnostic test for a trauma patient with loss of consciousness?
- Plain skull X-ray
- Head CT
- Carotid Doppler ultrasound
- Lumbar puncture
Question 10
A closed linear skull fracture usually does not require surgery, but a comminuted or depressed fracture may require surgery.
- True
- False
Question 11
Which finding is NOT listed as a sign of basilar skull fracture?
- Raccoon eyes
- Cerebrospinal fluid rhinorrhea
- Cerebrospinal fluid otorrhea
- Hemoptysis
Question 12
A head-trauma patient with loss of consciousness can be discharged home if the head CT is negative, there are no neurologic deficits, and a family member will frequently wake the patient over the next 24 hours to check for coma.
- True
- False
Question 13
A head-trauma patient becomes unconscious, then has a lucid interval, then becomes comatose. Which diagnosis is most likely?
- Epidural hematoma
- Subdural hematoma
- Diffuse axonal injury
- Cerebral contusion
Question 14
Epidural hematoma can cause an ipsilateral fixed and dilated pupil and contralateral hemiparesis.
- True
- False
Question 15
Which treatment should be done emergently for an epidural hematoma?
- Emergent craniotomy
- Observation with repeated CT scans
- Lumbar puncture
- Steroid therapy
Question 16
In a subdural hematoma, craniotomy is indicated when which finding is present?
- Deviation of the midline structures
- No deviation of midline structures
- Decreased intracranial pressure
- Gradual mental deterioration only
Question 17
If a subdural hematoma does not cause midline deviation, the usual approach is to lower intracranial pressure rather than perform craniotomy.
- True
- False
Question 18
Which of the following is a method used to decrease intracranial pressure?
- Elevating the head
- Lowering the head below body level
- Hyperventilating to a PaCO2 above 45 mmHg
- Giving large volumes of IV fluids
Question 19
CT showing diffuse blurring of the gray-white matter interface and multiple small punctate hemorrhages is most consistent with ______.
Fill in the blank
Question 20
In diffuse axonal injury, surgery is performed only if a hematoma is also present.
- True
- False
Question 21
What is the usual presentation of a subdural hematoma?
- Elderly or severely alcoholic patient with gradual mental deterioration
- Young athlete with sudden severe headache
- Abrupt loss of consciousness after a lucid interval
- Fever with nuchal rigidity
Question 22
Which measures may be used in treating a subdural hematoma?
- Craniotomy for midline deviation, ICP monitoring/lowering, and sedation or hypothermia
- Emergent craniotomy for all patients
- Lumbar puncture and steroid therapy
- Hyperventilation to a PaCO2 below 25 mmHg
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