TCRN TCRN Abdominal and Pelvic Trauma 3

Question 1

A trauma patient is diagnosed with a grade III splenic laceration on CT and is hemodynamically stable. What is the preferred management strategy?

Accepted Answer

Splenic artery embolization or nonoperative management

Answer

Hemodynamically stable patients with grade III splenic lacerations are candidates for nonoperative management or angioembolization to preserve splenic function.

Question 2

Which pelvic fracture pattern carries the highest risk of massive hemorrhage?

Accepted Answer

Anteroposterior compression type III (open-book)

Answer

APC type III open-book pelvic fractures disrupt the pelvic ring anteriorly and posteriorly, tearing the venous plexus and internal iliac vessels causing massive hemorrhage.

Question 3

A patient with blunt abdominal trauma has an elevated serum lipase. Which injury must be suspected?

Accepted Answer

Pancreatic injury

Answer

Elevated serum lipase after abdominal trauma suggests pancreatic injury, which can be subtle and missed on initial CT imaging.

Question 4

Damage control surgery for abdominal trauma focuses on which triad of physiologic derangements?

Accepted Answer

Hypothermia, acidosis, coagulopathy

Answer

The lethal triad of hypothermia, acidosis, and coagulopathy drives damage control decisions — definitive repair is delayed until physiology is corrected in the ICU.

Question 5

A trauma patient presents with gross hematuria after blunt abdominal trauma. CT reveals a grade IV renal laceration extending into the collecting system. What is the initial management?

Accepted Answer

Nonoperative management with repeat imaging if hemodynamically stable

Answer

Most renal lacerations, including grade IV, are managed nonoperatively in hemodynamically stable patients with repeat imaging to monitor for complications.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Abdominal and Pelvic Trauma 3