1. The first step in trauma assessment is:
(A) Disability assessment
(B) Exposure and environment control
(C) Airway maintenance
(D) Circulation assessment
2. The ABCDE approach in trauma stands for:
(A) Airway, Breathing, Circulation, Disability, Exposure
(B) Airway, Bleeding, Chest, Diaphragm, Examination
(C) Analgesia, Breathing, Circulation, Drugs, Examination
(D) Airway, Blood, Cardiac, Disability, Examination
3. In cervical spine injury, the most important first step is:
(A) Oxygen supplementation
(B) IV fluids
(C) Cervical collar immobilization
(D) Pain relief
4. The primary survey in trauma includes:
(A) Full history
(B) Detailed imaging
(C) Rapid identification of life-threatening injuries
(D) Laboratory tests
5. The most common cause of preventable death in trauma is:
(A) Airway obstruction
(B) Severe head injury
(C) Hemorrhage
(D) Spinal cord injury
6. Glasgow Coma Scale (GCS) assesses:
(A) Breathing
(B) Circulation
(C) Neurological status
(D) Spinal stability
7. A GCS score of 8 or less indicates:
(A) Mild head injury
(B) Moderate head injury
(C) Severe head injury
(D) Normal neurological function
8. The airway of an unconscious trauma patient should be secured by:
(A) Oropharyngeal airway
(B) Endotracheal intubation
(C) Tracheostomy
(D) Bag-mask ventilation only
9. In trauma, the most reliable indicator of adequate circulation is:
(A) Blood pressure
(B) Heart rate
(C) Urine output
(D) Skin color
10. The first sign of hypovolemia in trauma is:
(A) Hypotension
(B) Tachycardia
(C) Decreased urine output
(D) Altered sensorium
11. Which fluid is preferred in initial trauma resuscitation?
(A) Normal saline
(B) Ringer’s lactate
(C) 5% dextrose
(D) Dextran
12. Permissive hypotension in trauma is used in:
(A) Severe head injury
(B) Penetrating torso injuries
(C) Spinal injury
(D) Orthopedic trauma
13. The best site for intraosseous access in trauma is:
(A) Femoral shaft
(B) Tibial tuberosity
(C) Iliac crest
(D) Radius
14. The most common type of shock in trauma is:
(A) Septic shock
(B) Cardiogenic shock
(C) Hypovolemic shock
(D) Neurogenic shock
15. Neurogenic shock is characterized by:
(A) Hypertension and tachycardia
(B) Hypotension and bradycardia
(C) Hypotension and tachycardia
(D) Hypertension and bradycardia
16. Tension pneumothorax is best managed initially by:
(A) Needle decompression
(B) Endotracheal intubation
(C) Tube thoracostomy
(D) Chest X-ray
17. The classic triad of cardiac tamponade is:
(A) Tachypnea, hypoxia, bradycardia
(B) Hypotension, muffled heart sounds, raised JVP
(C) Hypertension, tachycardia, loud heart sounds
(D) Dyspnea, chest pain, sweating
18. FAST in trauma stands for:
(A) First aid surgical treatment
(B) Focused assessment with sonography for trauma
(C) Full arterial system test
(D) Fluid analysis and screening test
19. The most sensitive investigation for intra-abdominal bleeding in trauma is:
(A) FAST
(B) CT scan abdomen
(C) X-ray abdomen
(D) Diagnostic peritoneal lavage
20. The most common site of bleeding in blunt abdominal trauma is:
(A) Liver
(B) Spleen
(C) Kidney
(D) Pancreas
21. The golden hour in trauma refers to:
(A) Time to definitive care within 1 hour
(B) Time to airway intubation
(C) Time for IV fluid resuscitation
(D) First hour of surgery
22. Which fracture is most associated with fat embolism syndrome?
(A) Humerus
(B) Femur
(C) Radius
(D) Tibia
23. The most common early sign of fat embolism is:
(A) Petechiae
(B) Hypoxia
(C) Altered sensorium
(D) Fever
24. Cervical spine X-ray in trauma must include:
(A) C1 to C4 only
(B) C3 to C7 only
(C) Base of skull to T1
(D) C1 to C7 only
25. The management of open fractures in trauma involves:
(A) Immediate casting
(B) Broad-spectrum antibiotics and debridement
(C) Skin closure primarily
(D) Immobilization only
26. The most common site of traumatic aortic rupture is:
(A) Ascending aorta
(B) Aortic root
(C) Isthmus of aorta
(D) Abdominal aorta
27. The first priority in burn trauma management is:
(A) Airway assessment
(B) Fluid resuscitation
(C) Pain management
(D) Infection control
28. The fluid resuscitation formula for burns is:
(A) Parkland formula
(B) Brooke formula
(C) Evans formula
(D) Wallace rule
29. According to Parkland formula, the fluid required in first 24 hours is:
(A) 2 ml × %TBSA × body weight
(B) 4 ml × %TBSA × body weight
(C) 3 ml × %TBSA × body weight
(D) 5 ml × %TBSA × body weight
30. In trauma triage, patients with airway obstruction and shock are classified as:
(A) Green
(B) Red
(C) Yellow
(D) Black
31. The definitive airway in trauma is:
(A) Oropharyngeal airway
(B) Endotracheal tube
(C) Laryngeal mask airway
(D) Tracheostomy
32. The most common site of pelvic fracture bleeding is from:
(A) Internal iliac vein
(B) Internal iliac artery
(C) External iliac vein
(D) Femoral artery
33. The hallmark of basilar skull fracture is:
(A) Raccoon eyes and CSF rhinorrhea
(B) Severe headache only
(C) Immediate unconsciousness
(D) Hemiplegia
34. Cushing’s triad in raised intracranial pressure includes:
(A) Hypertension, bradycardia, irregular respiration
(B) Hypotension, tachycardia, apnea
(C) Hypertension, tachycardia, hyperventilation
(D) Hypotension, bradycardia, bradypnea
35. A patient with penetrating abdominal trauma and peritonitis requires:
(A) Observation
(B) CT scan
(C) Laparotomy
(D) Ultrasound
36. In spinal shock, the reflexes are:
(A) Hyperactive
(B) Absent
(C) Increased tone
(D) Normal
37. The most common cause of death in head injury patients is:
(A) Brainstem herniation
(B) Epidural hematoma
(C) Subdural hematoma
(D) Diffuse axonal injury
38. The classic lucid interval is seen in:
(A) Subarachnoid hemorrhage
(B) Epidural hematoma
(C) Subdural hematoma
(D) Brain contusion
39. The most important imaging modality in acute head trauma is:
(A) MRI
(B) CT scan
(C) X-ray skull
(D) Ultrasound
40. In trauma, the best way to control external bleeding is:
(A) Pressure dressing
(B) Tourniquet
(C) Elevation only
(D) Clamping vessels blindly
41. Massive transfusion protocol is defined as replacement of:
(A) 1 blood volume in 24 hours
(B) 50% blood volume in 24 hours
(C) 1000 ml in 1 hour
(D) 2 units in 2 hours
42. The most common electrolyte abnormality in massive transfusion is:
(A) Hyperkalemia
(B) Hypocalcemia
(C) Hyponatremia
(D) Hypermagnesemia
43. Which fracture is most commonly associated with hemorrhagic shock?
(A) Tibia
(B) Femur
(C) Radius
(D) Clavicle
44. In trauma, ATLS guidelines recommend oxygen delivery by:
(A) Nasal cannula
(B) Non-rebreather mask
(C) Room air
(D) Venturi mask
45. In trauma, the lethal triad consists of:
(A) Hypothermia, acidosis, coagulopathy
(B) Shock, tachycardia, hypothermia
(C) Acidosis, hypoxia, hyperkalemia
(D) Hypoglycemia, shock, coagulopathy
46. A patient with blunt chest trauma, absent breath sounds, and tracheal deviation should be treated with:
(A) Chest X-ray
(B) Needle decompression
(C) Intubation only
(D) Observation
47. The primary goal of damage control surgery in trauma is:
(A) Complete repair
(B) Rapid control of bleeding and contamination
(C) Cosmetic closure
(D) Long-term reconstruction
48. The most common site of diaphragmatic rupture in trauma is:
(A) Right dome
(B) Left dome
(C) Central tendon
(D) Both equally
49. In blunt chest trauma, flail chest is managed initially with:
(A) Needle decompression
(B) Analgesia and oxygen
(C) Immediate surgery
(D) Observation only
50. The most important principle of trauma care is:
(A) Definitive repair first
(B) Life before limb
(C) Detailed history before treatment
(D) Laboratory tests before intervention