ATLS Shock Assessment and Management 3

Question 1

A patient not responding to 2 units PRBC and 2 units FFP. Lactate 8, base deficit -12. What does this indicate?

Accepted Answer

Ongoing hemorrhage requiring source control

Answer

Rising lactate and worsening base deficit despite blood products indicate ongoing hemorrhage needing source control.

Question 2

What is the primary mechanism of death in untreated hemorrhagic shock?

Accepted Answer

Irreversible cellular ischemia and multi-organ failure

Answer

Prolonged hypoperfusion causes irreversible cellular ischemia and multi-organ failure.

Question 3

Tranexamic acid in trauma is most effective within what time frame?

Accepted Answer

3 hours

Answer

Per the CRASH-2 trial, TXA reduces mortality when given within 3 hours. After 3 hours, it may increase mortality.

Question 4

A trauma patient has narrow pulse pressure, tachycardia, and flat neck veins. Which shock type?

Accepted Answer

Hypovolemic shock

Answer

Narrow pulse pressure, tachycardia, and flat neck veins indicate hypovolemic shock.

Question 5

What is the role of vasopressors in initial hemorrhagic shock management?

Accepted Answer

Used only after adequate volume resuscitation and hemorrhage control

Answer

Vasopressors are used only after adequate volume and hemorrhage control, as vasoconstrictors in hypovolemia worsen tissue ischemia.

ATLS - Advanced Trauma Life Support Practice Test