ATLS Abdominal and Pelvic Trauma 3

Question 1

In a patient with a pelvic fracture and hemodynamic instability, what is the most appropriate initial intervention to control hemorrhage?

Accepted Answer

Application of a pelvic binder

Answer

A pelvic binder reduces pelvic volume and provides tamponade effect, serving as the first-line intervention for hemorrhage control in unstable pelvic fractures.

Question 2

Which type of pelvic fracture is most commonly associated with life-threatening hemorrhage?

Accepted Answer

Anterior-posterior compression (open book) type III

Answer

AP compression type III fractures create the greatest pelvic volume expansion, disrupting the posterior pelvic ring and major vascular structures.

Question 3

A patient has a positive FAST but is hemodynamically stable after a motor vehicle collision. CT reveals a Grade II liver laceration with no active extravasation. What is the recommended management?

Accepted Answer

Nonoperative management with serial monitoring

Answer

Hemodynamically stable patients with low-grade liver injuries and no active bleeding are best managed nonoperatively with close monitoring.

Question 4

During laparotomy for abdominal trauma, damage control surgery principles are indicated when the patient develops which triad?

Accepted Answer

Hypothermia, acidosis, and coagulopathy

Answer

The lethal triad of hypothermia, metabolic acidosis, and coagulopathy indicates physiologic exhaustion and mandates abbreviated surgery with temporary closure.

Question 5

Retroperitoneal duodenal injury is best diagnosed by which finding on CT scan?

Accepted Answer

Retroperitoneal air around the duodenum or right kidney

Answer

Retroperitoneal air around the duodenum or right kidney on CT is the hallmark finding of a retroperitoneal duodenal perforation.

ATLS - Advanced Trauma Life Support Practice Test

ATLS - Advanced Trauma Life Support Practice Test

ATLS Abdominal and Pelvic Trauma 3