TNCC Thoracic and Abdominal Trauma 2

Question 1

A patient with a stab wound to the left chest at the 5th intercostal space, anterior axillary line presents with hypotension and muffled heart sounds. The most likely diagnosis is:

Accepted Answer

Cardiac tamponade

Answer

Simple pneumothorax

Answer

Tension pneumothorax

Answer

Diaphragmatic rupture

Question 2

Which organ is most commonly injured in blunt abdominal trauma?

Accepted Answer

Spleen

Answer

Liver

Answer

Kidney

Answer

Pancreas

Question 3

A patient with blunt chest trauma develops progressive respiratory distress over 24-48 hours with bilateral diffuse infiltrates on chest X-ray. This presentation is most consistent with:

Accepted Answer

Pulmonary contusion progressing to ARDS

Answer

Delayed hemothorax

Answer

Bilateral simple pneumothorax

Answer

Aspiration pneumonia

Question 4

An open pneumothorax (sucking chest wound) should be immediately treated by:

Accepted Answer

Applying a three-sided occlusive dressing taped on three sides

Answer

Inserting a chest tube through the wound

Answer

Covering the wound completely with an airtight dressing taped on all four sides

Answer

Leaving the wound open to air to prevent tension pneumothorax

Question 5

A patient with blunt abdominal trauma has a positive FAST exam but is hemodynamically stable with a blood pressure of 128/78. The appropriate next step is:

Accepted Answer

CT scan of the abdomen and pelvis with IV contrast for injury grading

Answer

Emergent exploratory laparotomy

Answer

Repeat FAST in 6 hours

Answer

Discharge with return precautions

Question 6

Which clinical finding is most specific for esophageal perforation following penetrating neck or chest trauma?

Accepted Answer

Mediastinal air on chest X-ray (pneumomediastinum)

Answer

Hemoptysis

Answer

Tachycardia

Answer

Left-sided pleural effusion