Abdominal Trauma Flashcards
7 cards from real TNCC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Abdominal Trauma flashcards as text
A patient with a gunshot wound entering the left upper quadrant has a BP of 70/40 despite 2L of crystalloid. What is the most appropriate next intervention?
Answer: Immediate operative intervention (exploratory laparotomy)
A hemodynamically unstable patient with penetrating abdominal trauma requires immediate operative intervention; diagnostic imaging delays definitive hemorrhage control.
Which laboratory result best guides the decision to transfuse fresh frozen plasma (FFP) in a massively bleeding abdominal trauma patient?
Answer: INR greater than 1.5 or PT ratio elevated
FFP replaces all clotting factors and is indicated when the INR is elevated (>1.5), reflecting coagulopathy from hemorrhage or dilution.
A patient with abdominal trauma develops acute abdominal compartment syndrome (ACS). Which finding is the hallmark diagnostic criterion?
Answer: Intra-abdominal pressure (IAP) greater than 20 mmHg with new organ dysfunction
ACS is defined as sustained IAP >20 mmHg associated with new organ dysfunction; bladder pressure measurement is the standard surrogate for IAP.
Which vessel injury should be suspected when a patient with penetrating midline abdominal trauma develops profound shock with minimal external hemorrhage?
Answer: Abdominal aorta
The abdominal aorta runs midline and its injury causes rapid exsanguination; penetrating midline trauma with profound shock should raise immediate concern for aortic injury.
A patient with blunt abdominal trauma complains of left shoulder pain despite no shoulder injury. This is most likely due to:
Answer: Diaphragmatic irritation from splenic hemorrhage (Kehr's sign)
Kehr's sign is left shoulder pain caused by diaphragmatic irritation from blood or fluid beneath the left hemidiaphragm, commonly from splenic injury.
Which assessment finding in a patient with blunt abdominal trauma most strongly indicates the need for emergent operative intervention rather than CT imaging?
Answer: Positive FAST with hemodynamic instability refractory to resuscitation
Hemodynamic instability refractory to resuscitation with a positive FAST demonstrating hemoperitoneum mandates emergent operative hemorrhage control, not diagnostic imaging.
The 'lethal triad' of trauma (hypothermia, acidosis, coagulopathy) is most directly perpetuated by which resuscitation practice?
Answer: Infusing large volumes of room-temperature crystalloid
Large-volume crystalloid resuscitation worsens the lethal triad by diluting clotting factors (worsening coagulopathy), cooling the patient (hypothermia), and not correcting the metabolic acidosis.