Trauma MCQ questions

Question 1

32 yo male stabbed in abdomen. brought in by paramedics. alert and talking. good air entry. P130, BP 70/40, O2 sats not recording. what do you do next?

Answer 1

gain IV access and commence massive haemorrhage protocol.

Question 2

18yo male, motorcyclist, travelling at 40mph, skidded in wet conditions and has hit a tree. brought in by passing motorist. what would you do next?

Answer 2

assess airway and cervical spine.

Question 3

51 yo female, driver of car involved in head on collision at speed. airway clear, cervical spine controlled, high flow o2 on, breathing assessment adequate, distended abdomen, persistent hypotension despite 2 units o neg blood. what would you do next?

Answer 3

gain iv access and commence MHP
and apply a pelvic binder (distended abdomen)

Question 4

25yo male, fall from garage roof onto ground. GCS 15, complaining of R sided chest pain. airway clear. increasing breathlessness, now acutely distressed w RR 40, central cyanosis, shallow chest movements, little or no air entry on either side and tracheal deviation to left.

WDYDN?

Answer 4

needle decompression

Question 5

35 yo female. husband came from work and found her lying in bed.
pt restless, agitated and confused. skin dry, pupils dilated pulse 110, RR 20, gait ataxic, speech dysarthric. BM 4.1. what is likely toxidrome?

Answer 5

anticholinergic

Question 6

how would you approach pt who has overdosed on anticholinergic toxidrome?

Answer 6

ABCDE
supportive measures

Question 7

which antidote would she require for anticholinergic OD?

Answer 7

sodium bicarbonate.

Question 8

how would you figure out what someone has OD’d on?

Answer 8

ask family/friends, ambulance personnel, look at prev admissions, look at meds on clinic portal.

Question 9

what is ECG findings in an anticholinergic OD?

Answer 9

sinus tachycardia
widening of QRS
prolongation of QT interval

Question 10

which resource could you use to construct a mx plan for for toxidrome?

Answer 10

toxbase (National poisons information service)

Question 11

woman who OD’d made full recovery from poisoning what else do you need to consider prior to discharge?

Answer 11

mental health assessment
consideration of child protection issues/health visitor referral

Question 12

5yo female. child is drowsy and unsteady on her feet. on arrival pupils pinpointm snoring, RR 8, sats 90%. what are your immediate priorities?

Answer 12

airway mx
ABCDE assessment - don’t ever forget glucose

Question 13

what is toxidrome? pinpoint pupils, snoring RR low, sats low, drowsy.

Answer 13

opiate toxicity.

Question 14

what antidote would you consider for opiate OD?

Answer 14

titrate up naloxone (narcan) to effect.