Trauma Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Trauma. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Trauma Indian Medical PG Question 1: In an accident case, after the arrival of medical team, all should be done in early management except;
- A. Glasgow coma scale
- B. Check BP (Correct Answer)
- C. Stabilization of cervical vertebrae
- D. Check Respiration
Trauma Explanation: ***Check BP***
- In the **immediate/early management** of trauma (primary survey), while circulation assessment is crucial, the **initial assessment of circulation** focuses on:
- **Pulse rate and quality** (radial, carotid)
- **Capillary refill time**
- **Skin color and temperature**
- **Active hemorrhage control**
- **Formal blood pressure measurement** with a cuff, while important, is typically recorded during or after these rapid initial assessments, as it takes more time to obtain an accurate reading.
- In the context of this question, among the four options listed, BP measurement is relatively less immediate compared to the other life-saving priorities (airway protection, breathing assessment, C-spine stabilization, and GCS).
- **Note:** This is a nuanced distinction - BP is assessed during primary survey, but the other three options have more immediate life-threatening implications if not addressed.
*Glasgow coma scale*
- **GCS assessment** is part of the **"D" (Disability)** step in the ATLS primary survey.
- It is performed early to assess neurological status and level of consciousness.
- GCS <8 indicates need for **definitive airway protection** (intubation).
- This is a critical early assessment that guides immediate management decisions.
*Stabilization of cervical vertebrae*
- **C-spine immobilization** is part of the **"A" (Airway)** step - "Airway with cervical spine protection."
- It is performed **simultaneously** with airway assessment using a **rigid cervical collar**.
- This is the **first priority** in trauma management to prevent secondary spinal cord injury.
- All trauma patients should be assumed to have C-spine injury until proven otherwise.
*Check Respiration*
- **Respiratory assessment** is part of the **"B" (Breathing)** step in the ATLS primary survey.
- This involves checking:
- **Respiratory rate and pattern**
- **Chest wall movement**
- **Air entry bilaterally**
- **Signs of tension pneumothorax or flail chest**
- This is an immediate life-saving priority and must be assessed early.
Trauma Indian Medical PG Question 2: All of the following are types of traumatic brain injury EXCEPT:
- A. Contusion.
- B. None of the above. (Correct Answer)
- C. Concussion.
- D. Laceration.
Trauma Explanation: ***None of the above.***
- **All listed terms** - contusion, concussion, and laceration - are valid types of traumatic brain injury (TBI).
- Since the question asks for the exception and all three specific options are correct types of TBI, **"None of the above"** is the correct answer.
*Contusion.*
- A **brain contusion** is a bruise on the brain tissue caused by direct impact to the head.
- It involves localized bleeding and swelling within the brain parenchyma, visible on CT as areas of hyperdensity.
*Concussion.*
- A **concussion** is a mild traumatic brain injury resulting from rapid acceleration-deceleration forces.
- It causes temporary disruption of brain function without necessarily showing structural damage on imaging.
*Laceration.*
- A **brain laceration** is a tearing of brain tissue, representing a severe form of TBI.
- This typically occurs with penetrating head injuries or depressed skull fractures with bone fragments.
Trauma Indian Medical PG Question 3: A 30-year-old road traffic accident victim is being taken up for emergency laparotomy for haemoperitoneum and suspected multiorgan trauma. Which one of the following will be an indication for performing damage control surgery?
- A. Acidosis with pH < 7.32 (Correct Answer)
- B. Blood pressure < 100 mm Hg
- C. Coagulopathy
- D. Hypothermia < 36 °C
Trauma Explanation: ***Acidosis with pH < 7.32***
- This represents **severe metabolic acidosis** and is a specific, measurable component of the **"lethal triad"** (acidosis, hypothermia, coagulopathy) that mandates damage control surgery.
- pH < 7.32 (or < 7.2 in some protocols) is a **defined threshold** that indicates severe physiological derangement requiring abbreviated surgery.
- Severe acidosis impairs **cardiac contractility**, **enzyme function**, and **coagulation cascade**, making prolonged definitive repair dangerous.
- This specific laboratory value provides clear, objective criteria for the surgical decision.
*Blood pressure < 100 mm Hg*
- While **hypotension** indicates shock and requires aggressive resuscitation, blood pressure < 100 mmHg alone is not a specific criterion for damage control surgery.
- Damage control is indicated by the **lethal triad** components, not by blood pressure thresholds alone.
- Many trauma patients with BP < 100 mmHg can undergo definitive repair with adequate resuscitation.
*Coagulopathy*
- **Coagulopathy** is indeed a critical component of the "lethal triad" and a valid indication for damage control surgery.
- However, this option lacks **specific laboratory values** (e.g., INR > 1.5, PT > 16-19 seconds, platelets < 50,000) that would make it a definitive, measurable criterion.
- In contrast to the specific pH threshold given in option A, "coagulopathy" as stated here is less precise for decision-making.
*Hypothermia < 36 °C*
- While hypothermia is the third component of the "lethal triad," the typical threshold for damage control surgery is **core temperature < 35°C** (or < 34°C in most trauma protocols).
- Hypothermia < 36°C represents only **mild hypothermia** and is not generally considered an absolute indication for abbreviated surgery.
- More severe hypothermia (< 34-35°C) would be required to trigger damage control protocols.
Trauma Indian Medical PG Question 4: In the TRIAGE system for disaster management, which of the following color codes denotes "high-priority treatment and/or transfer"?
- A. Red (Correct Answer)
- B. Black
- C. Yellow
- D. Green
Trauma Explanation: ***Red***
- The **red tag** in the TRIAGE system signifies critical injuries requiring **immediate intervention** and transport to save life or limb.
- Patients tagged red have a high priority for treatment with a good chance of survival if attended to promptly.
- This represents the **highest priority** category for "high-priority treatment and/or transfer."
*Green*
- The **green tag** indicates patients with **minor injuries** who can walk and care for themselves.
- Also known as the "**walking wounded**," these patients require minimal or delayed medical attention.
- They have the **lowest priority** in disaster triage and can wait hours for treatment.
*Black*
- A **black tag** indicates the patient is **deceased** or has injuries so severe that survival is unlikely given the available resources.
- These patients are assigned a low priority for treatment to allocate resources to those with a better prognosis.
- Also called "**expectant**" in some systems.
*Yellow*
- The **yellow tag** designates patients with **serious, but non-life-threatening injuries** who can wait for treatment for a few hours.
- These patients are stable enough that they do not require immediate intervention but will need medical attention.
- Examples include fractures, moderate burns, or stable abdominal injuries.
Trauma Indian Medical PG Question 5: Which of the following statements are correct regarding ABCDE of trauma care ?
I. A stands for Airway with cervical spine protection
II. B stands for Breathing and ventilation
III. C stands for Control of massive external haemorrhage
IV. D stands for Disability (Neurological status)
Select the answer using the code given below :
- A. I, II and III
- B. I, II and IV (Correct Answer)
- C. II, III and IV
- D. I, III and IV
Trauma Explanation: ***I, II and IV***
- All statements I, II, and IV accurately describe components of the **ABCDE approach in trauma care**.
- **A** is for **Airway maintenance with cervical spine protection**, **B** for **Breathing and ventilation**, and **D** for **Disability (neurological status)**.
- These are the core components as per **ATLS (Advanced Trauma Life Support) guidelines**.
*I, II and III*
- This option is incorrect because statement III is **incomplete and inaccurate**.
- In the standard ATLS primary survey, **C stands for Circulation with hemorrhage control**, not just "Control of massive external haemorrhage."
- While controlling hemorrhage is a critical part of 'C', the primary focus is on assessing and managing **circulation** (shock, perfusion, bleeding).
- Note: ATLS 10th edition introduced **<C> for catastrophic hemorrhage** in tactical settings, but this is a separate step before A, not a replacement for C.
*II, III and IV*
- This option is incorrect as it omits statement I, which correctly describes **A as Airway with cervical spine protection**, the first and most critical step in trauma management.
- Statement III also incorrectly describes what 'C' represents in the ABCDE approach.
*I, III and IV*
- This option is incorrect because it omits statement II, which correctly identifies **B as Breathing and ventilation**, an essential assessment following airway management.
- Statement III is incomplete as it fails to mention that **C primarily stands for Circulation** (with hemorrhage control as one component).
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