Q.1 What is the first priority in trauma management according to ATLS?
Airway
Circulation
Disability
Exposure
Explanation - In trauma, airway assessment and management are the first step in the ABCDE approach to prevent hypoxia and death.
Correct answer is: Airway
Q.2 Which of the following indicates tension pneumothorax?
Bilateral wheezing
Tracheal deviation away from the affected side
Inspiratory stridor
Crepitus over sternum
Explanation - Tension pneumothorax presents with tracheal deviation, absent breath sounds, and hypotension.
Correct answer is: Tracheal deviation away from the affected side
Q.3 What is the most common cause of preventable death in trauma patients?
Airway obstruction
Hypovolemic shock
Hemorrhage
Sepsis
Explanation - Uncontrolled hemorrhage is the leading preventable cause of death in trauma patients.
Correct answer is: Hemorrhage
Q.4 In blunt abdominal trauma, which organ is most commonly injured?
Liver
Kidney
Spleen
Pancreas
Explanation - The spleen is the most frequently injured organ in blunt abdominal trauma due to its location and vascularity.
Correct answer is: Spleen
Q.5 Which imaging modality is most useful in hemodynamically unstable trauma patients?
CT scan
FAST (Focused Assessment with Sonography for Trauma)
MRI
X-ray
Explanation - FAST is quick, bedside, and ideal for unstable patients to detect intra-abdominal bleeding.
Correct answer is: FAST (Focused Assessment with Sonography for Trauma)
Q.6 In trauma resuscitation, what is the recommended ratio of packed red cells:plasma:platelets?
1:1:1
2:1:1
3:1:1
1:2:2
Explanation - Balanced transfusion with a 1:1:1 ratio improves outcomes in major hemorrhage protocols.
Correct answer is: 1:1:1
Q.7 Which of the following best describes Beck’s triad?
Hypotension, muffled heart sounds, distended neck veins
Bradycardia, hypertension, irregular respiration
Chest pain, diaphoresis, tachycardia
Abdominal pain, rigidity, guarding
Explanation - Beck’s triad is seen in cardiac tamponade, a potential complication of chest trauma.
Correct answer is: Hypotension, muffled heart sounds, distended neck veins
Q.8 Which fracture is most associated with fat embolism syndrome?
Humerus
Femur
Radius
Pelvis
Explanation - Long bone fractures, especially femur fractures, are highly associated with fat embolism.
Correct answer is: Femur
Q.9 What is the first-line management of open pneumothorax?
Intubation
Needle decompression
Three-sided occlusive dressing
Immediate thoracotomy
Explanation - A sucking chest wound is initially treated with a three-sided occlusive dressing to allow air out but not in.
Correct answer is: Three-sided occlusive dressing
Q.10 Which of the following is a classic sign of basilar skull fracture?
Battle’s sign
Cullen’s sign
Grey-Turner’s sign
Kehr’s sign
Explanation - Battle’s sign (postauricular ecchymosis) is characteristic of basilar skull fracture.
Correct answer is: Battle’s sign
Q.11 Which cervical spine level is most commonly injured in trauma?
C1
C2
C5-C6
C7
Explanation - The C5-C6 region is the most common site of cervical spine trauma due to high mobility.
Correct answer is: C5-C6
Q.12 Which clinical sign indicates diaphragmatic rupture?
Bowel sounds in chest
Abdominal distension
Decreased breath sounds at bases
Tachycardia
Explanation - Presence of bowel sounds in the chest cavity is a strong indicator of diaphragmatic rupture.
Correct answer is: Bowel sounds in chest
Q.13 Which artery is most commonly injured in pelvic fractures?
Superior gluteal artery
Internal iliac artery
Femoral artery
Middle meningeal artery
Explanation - Pelvic fractures often cause injury to branches of the internal iliac artery, leading to massive bleeding.
Correct answer is: Internal iliac artery
Q.14 What is the most common cause of death in patients with severe traumatic brain injury?
Hemorrhage
Brain swelling
Seizures
Sepsis
Explanation - Cerebral edema and raised intracranial pressure are the most common causes of death after severe TBI.
Correct answer is: Brain swelling
Q.15 In shock, which type shows increased cardiac output and decreased systemic vascular resistance?
Hypovolemic shock
Cardiogenic shock
Distributive shock
Obstructive shock
Explanation - Distributive shock (e.g., septic, anaphylactic) is characterized by low SVR and high CO.
Correct answer is: Distributive shock
Q.16 Which maneuver is contraindicated in suspected cervical spine injury?
Jaw thrust
Head tilt–chin lift
Oropharyngeal airway insertion
Endotracheal intubation
Explanation - Head tilt–chin lift should be avoided in cervical spine injury; jaw thrust is preferred.
Correct answer is: Head tilt–chin lift
Q.17 In blunt chest trauma, what is the most common cardiac injury?
Cardiac rupture
Myocardial contusion
Pericardial tamponade
Coronary artery dissection
Explanation - Myocardial contusion is the most frequent cardiac injury after blunt chest trauma.
Correct answer is: Myocardial contusion
Q.18 What is the best initial management for pelvic fracture with hemodynamic instability?
External fixation
CT angiography
Pelvic binder
Exploratory laparotomy
Explanation - Pelvic binders help reduce pelvic volume and bleeding in unstable pelvic fractures.
Correct answer is: Pelvic binder
Q.19 What is the recommended fluid for initial resuscitation in hemorrhagic shock?
Normal saline
Ringer’s lactate
Hypertonic saline
Dextrose 5%
Explanation - Balanced crystalloids like Ringer’s lactate are recommended for initial resuscitation.
Correct answer is: Ringer’s lactate
Q.20 Which of the following fractures is considered a marker of severe trauma?
Clavicle fracture
Femur fracture
First rib fracture
Fibula fracture
Explanation - First rib fracture is rare and usually indicates severe underlying thoracic trauma.
Correct answer is: First rib fracture
Q.21 What is the first step in managing massive external hemorrhage?
IV fluids
Tourniquet application
Blood transfusion
Exploratory surgery
Explanation - Controlling external bleeding with a tourniquet or direct pressure is the first priority.
Correct answer is: Tourniquet application
Q.22 Which clinical finding suggests compartment syndrome?
Pallor
Absent pulses
Pain out of proportion
Paresthesia
Explanation - The earliest and most sensitive sign of compartment syndrome is severe pain disproportionate to injury.
Correct answer is: Pain out of proportion
Q.23 In penetrating abdominal trauma, which of the following mandates laparotomy?
Evisceration
Hematuria
Stable vitals
Minor abrasions
Explanation - Evisceration after penetrating abdominal trauma is an absolute indication for exploratory laparotomy.
Correct answer is: Evisceration
Q.24 Which of the following is the definitive treatment for tension pneumothorax?
Needle decompression
Chest tube insertion
High-flow oxygen
Thoracotomy
Explanation - While needle decompression is temporizing, chest tube insertion is the definitive treatment.
Correct answer is: Chest tube insertion
Q.25 Which of the following best describes the lethal triad in trauma?
Hypotension, hypoxia, hyperkalemia
Acidosis, hypothermia, coagulopathy
Sepsis, acidosis, hyperglycemia
Hypothermia, bradycardia, dehydration
Explanation - The lethal triad is a vicious cycle of acidosis, hypothermia, and coagulopathy worsening trauma outcomes.
Correct answer is: Acidosis, hypothermia, coagulopathy