Trauma & Critical Care MCQs

Surgery · 5 free questions with answers & explanations.

1. A 30-year-old motorcyclist is brought to the emergency department following a high-speed collision. Primary survey reveals: airway patent, respiratory rate 32/min with absent breath sounds on the left, tracheal deviation to the right, oxygen saturation 80% on high-flow O2, blood pressure 80/50 mmHg, and distended neck veins. What is the immediate management?
2. A 25-year-old man sustains a stab wound to the left anterior chest in the 'cardiac box' (area between the clavicles, nipples, and sternal notch). He is brought to A&E with BP 70/40 mmHg, heart rate 128/min, distended neck veins, and muffled heart sounds. Chest X-ray shows a widened cardiac silhouette. What is the immediate surgical intervention?
3. A 35-year-old woman is involved in a motor vehicle accident. On assessment in the trauma bay, her GCS is 14, BP is 95/60 mmHg, HR is 118/min, and FAST examination reveals free fluid in Morison's pouch and the pelvis. After two large-bore IV cannulas are inserted and 1 litre of crystalloid is given, her BP improves to 100/65 mmHg temporarily but then drops again to 88/55 mmHg. CT abdomen confirms Grade IV liver laceration with active arterial extravasation. What is the next best step?
4. A 40-year-old man sustains blunt abdominal trauma in a road traffic accident. Initial CT abdomen shows a Grade II splenic laceration with no active extravasation and he is haemodynamically stable. He is managed non-operatively. On day 5, he suddenly develops severe left shoulder-tip pain and haemodynamic instability. Repeat CT shows a large peri-splenic haematoma with active haemorrhage. Which complication has occurred?
5. A 22-year-old man is brought to the emergency department after sustaining multiple injuries in a fall. His airway is intact, he is breathing spontaneously (RR 20/min), and his GCS is 15. His BP is 80/50 mmHg despite 2 litres of crystalloid. FAST is negative. Pelvic X-ray shows an open-book pelvic fracture. What is the most important immediate intervention to control haemorrhage?