ATLS Musculoskeletal Trauma 2

Question 1

A patient presents with a deformed, swollen thigh after a motorcycle collision. Distal pulses are weak. What is the most important initial step?

Accepted Answer

Apply traction splinting and reassess neurovascular status

Answer

Obtain X-rays before intervention

Answer

Prepare for immediate surgical fixation

Answer

Apply ice and elevate

Question 2

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

Accepted Answer

Pelvic ring disruption

Answer

Distal radius fracture

Answer

Tibial shaft fracture

Answer

Humeral shaft fracture

Question 3

A patient with a tibial fracture develops severe pain disproportionate to injury, pain with passive toe extension, and a tense compartment. What is the diagnosis and treatment?

Accepted Answer

Acute compartment syndrome; emergent fasciotomy

Answer

Deep vein thrombosis; anticoagulation

Answer

Fat embolism syndrome; supportive care

Answer

Fracture malreduction; re-splint

Question 4

What is the appropriate initial antibiotic for a Grade III open tibial fracture?

Accepted Answer

IV cefazolin plus an aminoglycoside

Answer

Oral amoxicillin

Answer

IV cefazolin alone

Answer

IV vancomycin alone

Question 5

24 hours after femoral fixation, a patient develops sudden dyspnea, petechial rash on chest, and confusion. Most likely diagnosis?

Accepted Answer

Fat embolism syndrome

Answer

Pulmonary embolism

Answer

Compartment syndrome

Answer

Hospital-acquired pneumonia

Question 6

What is the most appropriate action for a traumatic finger amputation?

Accepted Answer

Wrap in saline-moistened gauze, seal in bag, place on ice

Answer

Place amputated part directly on ice

Answer

Soak in warm saline

Answer

Apply tourniquet to stump and discard part