TNCC Abdominal Trauma 2

Question 1

A patient with blunt abdominal trauma has a positive FAST exam showing free fluid in the hepatorenal space. Which structure is most commonly injured with right upper quadrant fluid on FAST?

Accepted Answer

Liver

Answer

Spleen

Answer

Right kidney

Answer

Ascending colon

Question 2

Which mechanism of injury is most associated with hollow viscus (bowel) perforation in blunt abdominal trauma?

Accepted Answer

Lap belt restraint without shoulder harness

Answer

Lateral impact motor vehicle collision

Answer

Direct blow to the epigastrium

Answer

Rear-impact collision

Question 3

A trauma patient develops sudden hypotension 2 hours after a seat belt injury. Initial FAST was negative. What should be the priority diagnostic consideration?

Accepted Answer

Delayed hollow viscus injury with peritonitis

Answer

Tension pneumothorax

Answer

Neurogenic shock from spinal injury

Answer

Cardiac tamponade

Question 4

Which physical finding is most specific for diaphragmatic rupture in a patient with left-sided blunt thoracoabdominal trauma?

Accepted Answer

Bowel sounds auscultated in the left chest

Answer

Absent breath sounds on the left

Answer

Subcutaneous emphysema over the chest wall

Answer

Paradoxical chest wall movement

Question 5

During the secondary survey of a stab wound patient, you note evisceration of small bowel through the abdominal wound. What is the correct initial management?

Accepted Answer

Cover with a sterile, moist dressing and do not attempt to reinsert the bowel

Answer

Push the bowel back into the abdomen and apply a pressure dressing

Answer

Apply a dry sterile dressing and wrap tightly with an elastic bandage

Answer

Leave uncovered to allow visual monitoring during transport

Question 6

A patient with penetrating abdominal trauma has a gunshot wound to the right flank. Which retroperitoneal structure is at greatest risk of injury in this trajectory?

Accepted Answer

Right kidney

Answer

Spleen

Answer

Descending colon

Answer

Pancreas

Question 7

Which lab finding is the earliest indicator of significant intra-abdominal hemorrhage in a hemodynamically stable patient?

Accepted Answer

Elevated serum lactate

Answer

Elevated serum creatinine

Answer

Decreased serum albumin

Answer

Elevated alkaline phosphatase