Q.1 What is the first priority in trauma management according to ATLS guidelines?
Airway
Circulation
Disability
Exposure
Explanation - The ABCDE approach prioritizes securing the airway first to ensure oxygen delivery.
Correct answer is: Airway
Q.2 In suspected cervical spine injury, how should the airway be managed?
Head tilt-chin lift
Jaw thrust
Bag mask ventilation only
No intervention until X-ray
Explanation - Jaw thrust avoids neck movement and is safer in suspected cervical spine injury.
Correct answer is: Jaw thrust
Q.3 Which type of shock is most common in trauma patients?
Neurogenic shock
Cardiogenic shock
Hypovolemic shock
Septic shock
Explanation - Blood loss from injury is the leading cause of shock in trauma cases.
Correct answer is: Hypovolemic shock
Q.4 What is the first-line imaging tool in unstable trauma patients?
CT scan
X-ray
FAST ultrasound
MRI
Explanation - FAST (Focused Assessment with Sonography for Trauma) is rapid and non-invasive, ideal for unstable patients.
Correct answer is: FAST ultrasound
Q.5 In tension pneumothorax, the immediate life-saving procedure is:
Endotracheal intubation
Chest tube insertion
Needle decompression
CPR
Explanation - Needle decompression relieves pressure before definitive chest tube placement.
Correct answer is: Needle decompression
Q.6 Which cervical spine level injury can compromise breathing?
C2
C5
C7
T1
Explanation - High cervical injuries (C1-C3) can impair diaphragm function, causing respiratory failure.
Correct answer is: C2
Q.7 The 'golden hour' in trauma refers to:
Time for bleeding to stop naturally
Period after injury for best survival chance
Time to reach definitive surgery
Duration CPR should be continued
Explanation - The first 60 minutes after trauma is critical for resuscitation and survival.
Correct answer is: Period after injury for best survival chance
Q.8 What does the 'D' stand for in the primary survey (ABCDE)?
Diaphragm
Disability
Defibrillation
Drainage
Explanation - ‘D’ assesses neurological status, typically using AVPU or Glasgow Coma Scale.
Correct answer is: Disability
Q.9 Which sign is most suggestive of cardiac tamponade in trauma?
Beck’s triad
Kussmaul sign
Flail chest
Tachypnea
Explanation - Beck’s triad (hypotension, muffled heart sounds, JVD) is classic for tamponade.
Correct answer is: Beck’s triad
Q.10 What is the best initial fluid choice in hemorrhagic shock resuscitation?
Normal saline
Ringer’s lactate
Whole blood
Dextrose 5%
Explanation - Ringer’s lactate is preferred for initial volume replacement in trauma before blood is available.
Correct answer is: Ringer’s lactate
Q.11 Which fracture is most associated with fat embolism?
Humerus
Pelvis
Femur
Tibia
Explanation - Long bone fractures, especially femur, are a common source of fat emboli.
Correct answer is: Femur
Q.12 In the secondary survey, which of the following is assessed?
Airway obstruction
Pelvic fracture
Shock management
Cervical spine protection
Explanation - Secondary survey involves a full head-to-toe assessment including pelvis evaluation.
Correct answer is: Pelvic fracture
Q.13 What is the most common cause of preventable death in trauma?
Airway obstruction
Hypothermia
Hypotension
Uncontrolled hemorrhage
Explanation - Severe bleeding is the leading cause of preventable trauma deaths.
Correct answer is: Uncontrolled hemorrhage
Q.14 Which tool is used to quickly assess neurological status in trauma?
APGAR score
Glasgow Coma Scale
SOFA score
AVPU scale
Explanation - GCS is standard for evaluating level of consciousness in trauma patients.
Correct answer is: Glasgow Coma Scale
Q.15 What is the most reliable sign of compartment syndrome?
Pain out of proportion
Pallor
Pulselessness
Paresthesia
Explanation - Severe pain, especially with passive movement, is the earliest and most reliable sign.
Correct answer is: Pain out of proportion
Q.16 Which of the following is an indication for emergency thoracotomy in trauma?
Flail chest
Cardiac tamponade
Rib fracture
Pneumonia
Explanation - Thoracotomy is indicated in cases like cardiac tamponade with penetrating trauma.
Correct answer is: Cardiac tamponade
Q.17 Which spinal injury pattern suggests seatbelt syndrome?
Jefferson fracture
Chance fracture
Hangman’s fracture
Burst fracture
Explanation - Flexion-distraction injuries like Chance fracture are associated with seatbelt use.
Correct answer is: Chance fracture
Q.18 In pelvic fracture with shock, the best immediate intervention is:
Pelvic binder application
IV antibiotics
Exploratory laparotomy
CT scan
Explanation - Pelvic binders reduce bleeding by stabilizing the fracture early.
Correct answer is: Pelvic binder application
Q.19 Which organ is most commonly injured in blunt abdominal trauma?
Liver
Spleen
Kidney
Pancreas
Explanation - The spleen is the most commonly injured solid organ in blunt abdominal trauma.
Correct answer is: Spleen
Q.20 In penetrating abdominal trauma with unstable vitals, the next best step is:
CT scan
FAST scan
Exploratory laparotomy
Observation
Explanation - Unstable patients require immediate surgical intervention without delay.
Correct answer is: Exploratory laparotomy
Q.21 Which of the following is part of damage control resuscitation?
Aggressive crystalloids
Permissive hypotension
Delayed surgery
High tidal volume ventilation
Explanation - Permissive hypotension avoids dislodging clots until bleeding control is achieved.
Correct answer is: Permissive hypotension
Q.22 What is the triad of death in trauma?
Shock, sepsis, coagulopathy
Hypothermia, acidosis, coagulopathy
Hypotension, hypoxia, acidosis
Anemia, hypoxia, arrhythmia
Explanation - This vicious cycle significantly increases trauma mortality.
Correct answer is: Hypothermia, acidosis, coagulopathy
Q.23 What is the definitive management of open pneumothorax?
Needle decompression
Occlusive dressing and chest tube
Intubation
CPR
Explanation - A three-sided occlusive dressing followed by chest tube is the treatment.
Correct answer is: Occlusive dressing and chest tube
Q.24 Which of the following should be avoided in traumatic brain injury resuscitation?
Hypertonic saline
Mannitol
Hypotonic fluids
Head elevation
Explanation - Hypotonic fluids worsen cerebral edema in TBI.
Correct answer is: Hypotonic fluids
Q.25 What is the most appropriate site for needle decompression in tension pneumothorax?
Midclavicular line, 2nd intercostal space
Midaxillary line, 5th intercostal space
Sternal notch
Subcostal margin
Explanation - The standard site is the 2nd intercostal space in the midclavicular line.
Correct answer is: Midclavicular line, 2nd intercostal space