ATLS - Advanced Trauma Life Support Head Trauma Questions and Answers

Question 1

A 22-year-old male is brought to the emergency department after being struck on the side of the head with a bat.
He briefly lost consciousness at the scene but was awake and talking upon arrival, complaining only of a headache.
Thirty minutes later, he becomes drowsy, his right pupil becomes fixed and dilated, and he develops left-sided weakness.
What is the most likely diagnosis?

Accepted Answer

Epidural hematoma

Answer

Diffuse axonal injury

Answer

Acute subdural hematoma

Answer

Subarachnoid hemorrhage

Question 2

In the initial management of a patient with a severe traumatic brain injury (TBI), what is the primary goal according to ATLS principles?

Accepted Answer

To prevent secondary brain injury.

Answer

To administer mannitol immediately to all patients with a GCS of 8.

Answer

To obtain a head CT scan before initiating any fluid resuscitation.

Answer

To induce therapeutic hypothermia in the trauma bay.

Question 3

A trauma patient is assessed to have a Glasgow Coma Scale (GCS) score where they open their eyes to a painful stimulus, moan and make incomprehensible sounds, and withdraw their limb from pain. What is the patient's total GCS score?

Accepted Answer

8

Answer

7

Answer

9

Answer

6

Question 4

A 50-year-old female involved in a high-speed collision is noted to have a blood pressure of 190/110 mmHg, a heart rate of 48 bpm, and an irregular respiratory pattern. This set of vital signs is known as Cushing's triad and is a late sign of what critical condition?

Accepted Answer

Impending brainstem herniation

Answer

Spinal shock

Answer

Hemorrhagic shock Class IV

Answer

Fat embolism syndrome

Question 5

Which of the following is an appropriate, temporary measure for a patient with an acute traumatic brain injury who is demonstrating signs of active brain herniation, such as a unilaterally blown pupil?

Accepted Answer

Brief, controlled hyperventilation to a target PaCO2 of 30-35 mmHg

Answer

Administration of high-dose corticosteroids

Answer

Prophylactic hyperventilation to a PaCO2 below 25 mmHg for several hours

Answer

Immediate placement of a ventricular drain in the emergency department

Question 6

According to ATLS 10th edition guidelines, what is the minimum target systolic blood pressure (SBP) that should be maintained in a 60-year-old patient with a traumatic brain injury to prevent secondary injury from hypotension?

Accepted Answer

≥100 mmHg

Answer

≥90 mmHg

Answer

≥110 mmHg

Answer

≥120 mmHg