Emergency and Trauma Radiology (FAST, Polytrauma CT, Imaging in ATLS) MCQs

Radiology · 20 free questions with answers & explanations.

1. A 28-year-old man arrives after a high-speed MVA. On FAST examination, anechoic fluid is seen in the hepatorenal recess (Morison's pouch) and in the pelvis. His BP is 80/50 mmHg. According to ATLS principles, the next IMMEDIATE step is:
2. On a focused CT chest performed after blunt thoracic trauma, a 'bloody crescent' sign is noted posterior to the aortic arch. What does this sign indicate?
3. In a polytrauma patient who is haemodynamically stable, a CT of the abdomen shows a Grade IV splenic laceration with an area of active arterial contrast extravasation ('blush'). The most appropriate next step is:
4. A seat-belt injury pattern on axial CT shows: chance-type fracture of L2, mesenteric infiltration with bowel wall thickening, and free fluid without solid organ injury. The hollow viscus injury rate in this combination (seat-belt sign + chance fracture) is approximately:
5. On FAST examination, the pericardial space is interrogated via the subxiphoid window. Which of the following most accurately indicates a positive (haemopericardium) finding?
6. A 28-year-old man is brought after a high-speed road traffic accident. On FAST examination, an anechoic collection is seen in Morrison's pouch. Which anatomical space is being assessed by this probe position?
7. In a polytrauma patient undergoing CT of the abdomen, active arterial extravasation of contrast is identified within a splenic laceration. On delayed phase imaging the blush has increased in size. Which of the following best characterizes this finding?
8. A 35-year-old motorcyclist has blunt chest trauma. CXR shows widened mediastinum (>8 cm), loss of aortopulmonary window, rightward tracheal deviation, and a left-sided pleural cap. What is the most likely diagnosis?
9. On CT of a trauma patient, the following injuries are identified: bilateral perirenal hematoma, retroperitoneal gas, and a 'sentinel clot' of high density adjacent to the duodenum. What injury pattern does this sentinel clot suggest?
10. A trauma patient with pelvic fracture (open-book) has profuse arterial hemorrhage on CT. Angiography reveals bilateral internal pudendal artery bleeding. What is the first-line radiological intervention?
11. A 28-year-old motorcyclist sustains high-speed trauma. FAST ultrasound reveals free fluid in Morrison's pouch. Which of the following is the most appropriate next step in a haemodynamically unstable patient?
12. On a whole-body CT of a polytrauma patient, an aortic injury at the isthmus shows a contained pseudoaneurysm with periaortic haematoma. According to current guidelines, which is the preferred management?
13. A CT of the head performed immediately after a road traffic accident shows a hyperdense biconvex extra-axial collection with a lucid interval history. The collection crosses the midline but is limited by a suture. What is the most likely diagnosis?
14. The Organ Injury Scale (OIS) for splenic trauma assigns grade III to which of the following CT findings?
15. In a pelvic ring fracture on CT, which finding is the most specific predictor of major arterial haemorrhage requiring angioembolisation?
16. A 28-year-old male presents after a high-speed motor vehicle accident. FAST examination is performed. Which of the following is the MOST sensitive ultrasound window for detecting free intraperitoneal fluid in FAST?
17. On CT scan of a polytrauma patient, the bowel wall shows pneumatosis intestinalis (intramural gas), portal venous gas, and 'shock bowel' pattern (diffuse bowel wall thickening with hyperenhancement). These findings together are MOST consistent with:
18. A 35-year-old male with blunt abdominal trauma has CT showing a grade IV splenic laceration with a 3 cm pseudoaneurysm and active haemorrhage (contrast blush). ATLS guidelines support which of the following interventions as the FIRST choice in a haemodynamically stable patient?
19. On CT brain in a 22-year-old victim of assault, there is a biconvex hyperdense collection at the temporal region with a 'swirl sign' (mixed density). The swirl sign in acute intracranial haemorrhage indicates:
20. A motorcyclist presents with unequal pulses and widened mediastinum on chest X-ray after trauma. CT aortography shows an intimal flap at the aortic isthmus (just distal to the left subclavian artery). This location is the most common site for traumatic aortic injury because: