CFA Hemorrhage & Emergency Response 3

Question 1

During a laparotomy, the surgeon inadvertently nicks the inferior vena cava (IVC). The FIRST response by the first assistant should be to:

Accepted Answer

Apply direct finger pressure over the injury site

Answer

Direct finger or sponge pressure on an IVC injury is the immediate priority to control massive venous hemorrhage while the surgical team prepares definitive repair.

Question 2

Damage control surgery (DCS) for hemorrhage primarily aims to:

Accepted Answer

Control hemorrhage and contamination while deferring complex repairs

Answer

Damage control surgery focuses on rapid hemorrhage control and contamination prevention, leaving complex reconstructions for a later operation after physiologic stabilization.

Question 3

Which electrolyte abnormality is MOST commonly associated with massive blood transfusion and can worsen coagulopathy?

Accepted Answer

Hypocalcemia

Answer

Stored blood contains citrate which chelates ionized calcium; massive transfusion depletes calcium needed for coagulation factor activation, worsening coagulopathy.

Question 4

A patient undergoing an emergent splenectomy begins showing a prolonged PT/INR, low fibrinogen, and thrombocytopenia. This constellation MOST likely represents:

Accepted Answer

Disseminated intravascular coagulation (DIC)

Answer

DIC presents with simultaneous consumption of clotting factors and platelets, producing elevated PT, low fibrinogen, and thrombocytopenia in a massively bleeding patient.

Question 5

The 'lethal triad' of trauma refers to the combination of:

Accepted Answer

Hypothermia, acidosis, and coagulopathy

Answer

The lethal triad — hypothermia, acidosis, and coagulopathy — creates a self-perpetuating cycle that dramatically increases mortality in severely injured patients.

CFA Practice Test

CFA Practice Test

CFA Hemorrhage & Emergency Response 3