Q.1 A 25-year-old man is brought to the ER after a road traffic accident. His airway is noisy, and he is unable to speak. What is the immediate next step?
Give IV fluids
Perform a jaw thrust and secure the airway
Start chest compressions
Administer high-flow oxygen only
Explanation - Airway management is always the first priority in trauma (ABCDE). A noisy airway with inability to speak indicates partial obstruction.
Correct answer is: Perform a jaw thrust and secure the airway
Q.2 Which of the following is the first priority in Advanced Trauma Life Support (ATLS)?
Airway
Circulation
Disability
Exposure
Explanation - The ATLS protocol emphasizes the ABCDE approach: Airway is always assessed first.
Correct answer is: Airway
Q.3 A patient with blunt abdominal trauma presents with hypotension and distended abdomen. What is the most likely diagnosis?
Splenic rupture
Appendicitis
Gastritis
Small bowel obstruction
Explanation - Splenic rupture is a common cause of intra-abdominal bleeding after blunt trauma leading to hypotension and abdominal distension.
Correct answer is: Splenic rupture
Q.4 Which of the following is the definitive management of tension pneumothorax?
Chest X-ray before intervention
Needle decompression followed by chest tube
High-flow oxygen only
CPR immediately
Explanation - Tension pneumothorax is a life-threatening condition managed immediately with needle decompression followed by tube thoracostomy.
Correct answer is: Needle decompression followed by chest tube
Q.5 In hypovolemic shock, which of the following is most commonly decreased?
Pulse rate
Urine output
Respiratory rate
Mental alertness
Explanation - Hypovolemia leads to reduced renal perfusion, causing oliguria/anuria.
Correct answer is: Urine output
Q.6 A 35-year-old male presents after a car accident with unequal pupils and altered consciousness. What is the most likely cause?
Subdural hematoma
Epidural hematoma
Stroke
Meningitis
Explanation - Epidural hematomas are associated with a lucid interval followed by rapid deterioration, often with anisocoria due to uncal herniation.
Correct answer is: Epidural hematoma
Q.7 The triad of hypotension, muffled heart sounds, and jugular venous distension is characteristic of:
Tension pneumothorax
Cardiac tamponade
Massive hemothorax
Pulmonary embolism
Explanation - Beck’s triad is diagnostic for cardiac tamponade, a life-threatening emergency.
Correct answer is: Cardiac tamponade
Q.8 Which type of shock is most common in trauma patients?
Neurogenic shock
Cardiogenic shock
Hypovolemic shock
Septic shock
Explanation - Blood loss is the leading cause of shock in trauma, making hypovolemic shock most common.
Correct answer is: Hypovolemic shock
Q.9 What is the first-line fluid in resuscitation of a hypovolemic trauma patient?
5% Dextrose
Normal saline
0.45% Saline
Albumin
Explanation - Isotonic crystalloids like normal saline or Ringer’s lactate are first-line fluids for initial resuscitation.
Correct answer is: Normal saline
Q.10 A young trauma patient presents with open femur fracture and active bleeding. What is the immediate next step?
Take to operating room
Apply direct pressure and stabilize fracture
Give antibiotics only
Send for CT scan
Explanation - Bleeding control and temporary stabilization are the first steps before definitive surgery.
Correct answer is: Apply direct pressure and stabilize fracture
Q.11 The most reliable early sign of hypovolemic shock is:
Low blood pressure
Increased heart rate
Cold clammy skin
Confusion
Explanation - Tachycardia is the earliest and most reliable indicator of hypovolemia before hypotension occurs.
Correct answer is: Increased heart rate
Q.12 Which of the following is true about flail chest?
It is caused by single rib fracture
It requires immediate intubation always
It results in paradoxical chest wall movement
It does not affect breathing
Explanation - Flail chest occurs when multiple adjacent rib fractures create a floating segment that moves paradoxically during respiration.
Correct answer is: It results in paradoxical chest wall movement
Q.13 A patient with blunt chest trauma presents with absent breath sounds on the left and tracheal deviation to the right. What is the likely diagnosis?
Massive hemothorax
Tension pneumothorax
Simple pneumothorax
Pulmonary contusion
Explanation - Classic signs include absent breath sounds, hyperresonance, and tracheal deviation away from affected side.
Correct answer is: Tension pneumothorax
Q.14 Which of the following is NOT part of the primary survey in trauma?
Airway
Breathing
Circulation
CT scan
Explanation - Primary survey is ABCDE; imaging is part of secondary survey.
Correct answer is: CT scan
Q.15 In a patient with suspected spinal cord injury, the most important initial step is:
Log roll with spinal immobilization
IV fluids
Immediate CT scan
Steroid administration
Explanation - Preventing further spinal cord damage with immobilization is the first priority.
Correct answer is: Log roll with spinal immobilization
Q.16 Which fracture is most commonly associated with hypovolemic shock?
Clavicle fracture
Pelvic fracture
Humerus fracture
Radius fracture
Explanation - Pelvic fractures can cause massive retroperitoneal bleeding and shock.
Correct answer is: Pelvic fracture
Q.17 A trauma patient presents with GCS 6. What is the immediate management?
Give IV fluids
Secure airway with intubation
Order head CT scan
Start mannitol
Explanation - GCS <8 indicates severe head injury requiring airway protection with intubation.
Correct answer is: Secure airway with intubation
Q.18 Which of the following is most commonly missed in primary trauma survey?
Airway obstruction
Tension pneumothorax
Cardiac tamponade
Spinal injury
Explanation - Spinal injuries can be easily missed unless carefully checked during exposure and log roll.
Correct answer is: Spinal injury
Q.19 Which burn depth is characterized by blister formation?
Superficial
Superficial partial thickness
Deep partial thickness
Full thickness
Explanation - Superficial partial thickness burns present with blisters and are painful.
Correct answer is: Superficial partial thickness
Q.20 The first maneuver in controlling external hemorrhage is:
Tourniquet application
Direct pressure
Surgical intervention
Packing wound with gauze
Explanation - Direct pressure is the simplest and most effective first step to control bleeding.
Correct answer is: Direct pressure
Q.21 A patient with head trauma develops bradycardia, hypertension, and irregular respirations. This indicates:
Hypovolemic shock
Cushing’s triad
Brain death
Seizure
Explanation - Cushing’s triad is a sign of raised intracranial pressure due to impending herniation.
Correct answer is: Cushing’s triad
Q.22 In trauma resuscitation, what does the 'D' in ABCDE stand for?
Deformities
Disability
Drainage
Diuresis
Explanation - D stands for Disability, referring to quick neurological assessment (AVPU/GCS).
Correct answer is: Disability
Q.23 The Parkland formula for burn resuscitation calculates fluid requirement based on:
Weight and depth of burn
Weight and total body surface area burned
Age and weight
Surface area only
Explanation - Parkland formula: 4 ml × body weight (kg) × %TBSA burn = 24-hour fluid requirement.
Correct answer is: Weight and total body surface area burned
Q.24 What is the most important immediate intervention in an unconscious patient with suspected poisoning?
IV fluids
Secure airway
Give antidote
Gastric lavage
Explanation - Airway protection is always the first priority in any unconscious patient.
Correct answer is: Secure airway
Q.25 A trauma patient in shock is found to have flat neck veins. Which type of shock is most likely?
Cardiogenic
Hypovolemic
Obstructive
Septic
Explanation - Flat neck veins suggest low venous return, typical of hypovolemic shock.
Correct answer is: Hypovolemic