ITLS - International Trauma Life Support Geriatric Trauma Considerations Questions and Answers

Question 1

An 82-year-old female falls and complains of hip pain.
Her vital signs are BP 110/70 mmHg, pulse 68/min, and respirations 20/min.
Her skin is cool and pale.
Her family states she takes metoprolol for hypertension.
Which finding is most concerning given her medication history?

Accepted Answer

The heart rate of 68/min

Answer

The blood pressure of 110/70 mmHg

Answer

The respiratory rate of 20/min

Answer

The presence of hip pain

Question 2

Which age-related physiological change is the primary reason that a seemingly minor head injury can cause a life-threatening subdural hematoma in a geriatric patient?

Accepted Answer

Cerebral atrophy causing stretching of the bridging veins

Answer

Increased intracranial pressure due to decreased CSF absorption

Answer

Thickening of the dura mater, making it less pliable

Answer

Arteriosclerosis of the cerebral arteries, making them prone to rupture

Question 3

You are treating an 80-year-old male who was a restrained driver in a low-speed, rear-end collision. He denies neck pain but complains of significant weakness and tingling in both of his hands, while his leg strength remains mostly intact. This pattern of neurologic deficit is most characteristic of which condition?

Accepted Answer

Central Cord Syndrome

Answer

Anterior Cord Syndrome

Answer

Brown-Séquard Syndrome

Answer

Cauda Equina Syndrome

Question 4

When managing a 78-year-old trauma patient, which of the following principles is most important to consider?

Accepted Answer

A ground-level fall should be treated with a high index of suspicion for severe injury.

Answer

A normal blood pressure reading reliably rules out the presence of shock.

Answer

The mechanism of injury is the most reliable predictor of injury severity.

Answer

Geriatric patients require larger volumes of IV fluids to compensate for dehydration.

Question 5

A 75-year-old patient with multiple rib fractures is at a significantly higher risk for developing pneumonia compared to a younger patient primarily because of:

Accepted Answer

Decreased chest wall compliance and an ineffective cough leading to atelectasis.

Answer

A pre-existing higher likelihood of having a smoking history.

Answer

An increased probability that the fractured ribs will puncture the lung.

Answer

A blunted inflammatory response that cannot fight infection.

Question 6

You are treating a confused 88-year-old male with a forehead hematoma after a fall. He is taking warfarin, an anticoagulant. His BP is 100/60 mmHg and his pulse is 110/min. What is the single most critical management priority for this patient in the prehospital setting?

Accepted Answer

Prioritizing rapid transport to a trauma center capable of managing intracranial hemorrhage.

Answer

Administering a 2-liter fluid bolus to treat hypotension.

Answer

Applying a cervical collar and assuming his confusion is his baseline.

Answer

Obtaining a detailed history of his dementia from family members.