1. Cardiac tamponade after trauma a. is seldom life-threatening b. can be excluded by an upright, AP chest x-ray c. can be confused with a tension pneumothorax d. causes a fall in systolic pressure of > 15 mm Hg with expiration e. most commonly occurs after blunt injury to the anterior chest wall 2. Which one of the following statements regarding patients with thoracic spine injuries is TRUE? a. Log-rolling may be destabilizing to fractures from T-12 to L-1. b. Adequate immobilization can be accomplished with the scoop stretcher. c. Spinal cord injury below T-10 usually spares bowel and bladder function. d. Hyperflexion fractures in the upper thoracic spine are inherently unstable. e. These patients rarely present with spinal shock in association with cord injury. 3. Absence of breath sounds and dullness to percussion over the left hemithorax are fmdings best explained by a. Left hemothorax. b. c. d. e. f. g. cardiac contusion h. left simple pneumothorax i. left diaphragmatic rupture j. right tension pneumothorax. 4. A young man sustains a gunshot wound to the abdomen and is brought promptly to the emergency department by prehospital personnel. His skin is cool and diaphoretic, and he is confused. His pulse is thready and his femoral pulse is only weakly palpable. The defmitive treatment in managing this patient is to a. administer 0-negative blood b. applyextemal warming devices. c. Control internal hemorrhage operatively d. apply the pneumatic antishock garment e. infuse large volumes of intravenous crystalloid solution. 5. To establish a diagnosis of shock, a. systolic blood pressure must be below 90 mm Hg. b. the presence of a closed head injury should be excluded c. acidosis should be present by arterial blood \gas analysis d. the patient must fail to respond to intravenous fluid infusion. e. clinical evidence of inadequate organ perfusion must be present. 6. A 23-year-old man is brought immediately to the emergency department from the hospital' s parking lot where he was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing and has a thready pulse. However, he is unconscious and has no detectable blood pressure. Optimal immediate management is to a. perform diagnostic peritoneal lavage. b. initiate infusion of packed red blood cells. c. insert a nasogastric tube and urinary catheter. d. transfer the patient to the operating room, while initiating fluid therapy. e. initiate fluid therapy to return his blood pressure to normotensive 7. An electrician is electrocuted by a downed power line after a thunderstorm. He apparently made contact with the wire at the level of the right mid thigh. In the emergency department, his vital signs are normal and no dysrhythmia is noted on ECG. On examination, there is an exit wound on the bottom of the right foot. His urine is positive for blood by dip stick but no RBCs are seen microscopically. Initial management should include a. immediate angiography. b. aggressive fluid infusion. c. intravenouspyleography. d. debridement of necrotic muscle. e. admission to the intensive care unit for observation.