ITLS Head and Spinal Trauma 2

Question 1

A patient struck in the head with a baseball bat initially loses consciousness, then regains awareness and appears lucid for 30 minutes before rapidly deteriorating.
What type of intracranial hemorrhage is most likely?

Accepted Answer

Epidural hematoma

Answer

Subdural hematoma

Answer

Subarachnoid hemorrhage

Answer

Intracerebral hemorrhage

Question 2

What clinical signs indicate Cushing's triad, and what does it signify?

Accepted Answer

Hypertension, bradycardia, and irregular respirations indicating critically elevated intracranial pressure

Answer

Tachycardia, hypotension, and tachypnea indicating hemorrhagic shock

Answer

Fever, neck rigidity, and altered mental status indicating meningitis

Answer

JVD, muffled heart sounds, and hypotension indicating cardiac tamponade

Question 3

A trauma patient has unequal pupils—the right pupil is fixed and dilated while the left is reactive. What does this finding most likely indicate?

Accepted Answer

Right-sided uncal herniation compressing the right oculomotor nerve

Answer

Direct trauma to the right eye

Answer

Left-sided brain injury with contralateral effect

Answer

Normal pupillary variation

Question 4

A motorcycle crash victim has weakness and loss of pain/temperature sensation in both arms but relatively preserved leg function. What spinal cord injury pattern is this?

Accepted Answer

Central cord syndrome

Answer

Anterior cord syndrome

Answer

Brown-Séquard syndrome

Answer

Complete spinal cord transection

Question 5

What is the appropriate blood pressure target when managing a trauma patient with both a severe traumatic brain injury (GCS 6) and hemorrhagic shock?

Accepted Answer

Maintain systolic BP above 90 mmHg to protect cerebral perfusion, even though this conflicts with permissive hypotension strategy

Answer

Allow permissive hypotension to protect the clots

Answer

Target systolic BP of 60-70 mmHg

Answer

Blood pressure management is not important in polytrauma

Question 6

A patient with a suspected cervical spine injury is vomiting while secured to a backboard. What is the immediate management?

Accepted Answer

Tilt the entire backboard to the side as a unit while suctioning

Answer

Suction the airway while keeping the patient supine

Answer

Remove the cervical collar and turn only the head

Answer

Sit the patient upright on the backboard