Trauma Reports CNE/CME Objectives
To help physicians:
a.) discuss conditions that should increase suspicion for traumatic injuries;
b.) describe the various modalities used to identify different traumatic conditions;
c.) cite methods of quickly stabilizing and managing patients; and
d.) identify possible complications that may occur with traumatic injuries.
1. Which anatomical border would not prompt suspicion of an intra-abdominal injury following penetrating trauma?
A. Nipple line
B. Inguinal ligaments anteriorly
C. Tip of the scapula
E. Inferior gluteal folds
2. Most penetrating thoracic trauma requires operative intervention.
3. Focused Assessment for Sonography of Trauma (FAST) for pericardial fluid following penetrating chest trauma is:
B. easily repeatable.
C. highly sensitive and specific.
D. the first diagnostic modality of choice.
E. All of the above
4. Patients who present without symptoms of intra-thoracic injury following penetrating chest trauma require:
A. an initial chest x-ray and observation alone.
B. serial chest x-rays at least 3 hours apart.
C. observation alone.
D. an initial chest x-ray and discharge.
5. Which of the following findings on ultrasounds suggests the presence of a pneumothorax?
A. Stratosphere sign
B. Comet tails
C. Lung sliding
D. Seashore sign
6. Which of the following patients has the greatest chance of survival following ED thoracotomy?
A. Stab to chest trauma with no "Signs of Life" in the field or on admission
B. Witnessed cardiac arrest following blunt trauma
C. Loss of "Signs of Life" in the emergency department and isolated stab to the heart with evidence of pericardial tamponade on ultrasound
D. Gunshot wound to the chest with 5 minutes of pre-hospital CPR
7. Which of the following does not increase mortality following penetrating abdominal trauma?
D. Hypotension on admission
E. Fluid seen on ultrasound (FAST)
8. Which of the following is not an acceptable method for managing anterior abdominal stab wounds?
A. Explorative laparotomy
B. Local wound exploration
C. Wound probing
D. Serial physical exams
E. Computed tomography
9. Which of the following is effective in evaluating penetrating flank/back injuries?
A. Local wound exploration
B. Serial physical exam
C. Diagnostic peritoneal lavage
D. Computed tomography
E. B and D
10. Triple contrast CT scan for penetrating torso trauma:
A. identifies all injuries.
B. has high sensitivity and specificity for determining the need for laparotomy following penetrating injury.
C. can identify patients who may be safely discharged from the emergency department.
D. uses three times as much radiation as a traditional CT scan.
E. B and C
Answers: 1. D, 2. B, 3. E, 4. B, 5. A, 6. C, 7. E, 8. C, 9. E, 10. E.