ATLS Abdominal and Pelvic Trauma 2

Question 1

A patient arrives after a motorcycle crash with a rigid, distended abdomen and hypotension. What is the most appropriate initial diagnostic study?

Accepted Answer

Focused Assessment with Sonography for Trauma (FAST)

Answer

FAST is the preferred initial assessment in hemodynamically unstable trauma patients as it rapidly identifies free intraperitoneal fluid without delaying resuscitation.

Question 2

Which organ is most commonly injured in blunt abdominal trauma?

Accepted Answer

Spleen

Answer

The spleen is the most commonly injured solid organ in blunt abdominal trauma due to its anatomic position and relatively fragile parenchyma.

Question 3

A stab wound to the left lower chest at the 7th intercostal space should raise suspicion for injury to which abdominal organ?

Accepted Answer

Spleen

Answer

The thoracoabdominal region contains the upper abdominal organs beneath the diaphragm, and left-sided wounds in this zone frequently injure the spleen.

Question 4

What is the most reliable indicator of intra-abdominal hemorrhage requiring surgical intervention in an unstable trauma patient?

Accepted Answer

Positive FAST exam

Answer

A positive FAST exam in a hemodynamically unstable patient is the most reliable bedside indicator of significant intra-abdominal hemorrhage requiring emergent surgical exploration.

Question 5

A hemodynamically stable patient with a Grade III splenic laceration on CT is best managed with which approach?

Accepted Answer

Nonoperative management with observation

Answer

Hemodynamically stable patients with Grade I-III splenic injuries are typically managed nonoperatively with serial abdominal exams, hemoglobin monitoring, and bed rest, achieving success rates of over 90%.

ATLS - Advanced Trauma Life Support Practice Test

ATLS - Advanced Trauma Life Support Practice Test

ATLS Abdominal and Pelvic Trauma 2