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Polytrauma Management MCQs
Trauma Mastery | Set 1 (Q1-50) | Question to Answer | Detailed Teaching Explanation
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Master revision sheet — 39 high-yield facts
Primary survey
ABC; life before limb
Class I shock
≤15%, HR <100, urine >30
Class II
15–30%, HR >100, urine 20–30
Class III
30–40%, HR >120, urine 5–15, fluid + blood
Class IV
>40%, HR >140, negligible urine
Neurogenic shock
Hypotension + bradycardia + warm skin
Septic shock
↑ cardiac index, ↓ SVR, ↓ CVP
SIRS
≥2 criteria
SIRS numbers
HR >90; WBC <4k/>12k; RR >20/PCO₂ <32; T <36/>38
Initial access
Two large-bore IVs
Initial crystalloid
2 L LR or NS
Severe hemorrhage
PRBC:FFP:platelets = 1:1:1
Emergency donor
O negative
Type-specific blood
~10 min
Fully crossmatched
~60 min
Platelet storage
20–24°C + gentle agitation
Massive transfusion
Dilutional thrombocytopenia most common
Citrate
Hypocalcemia
Resuscitation assessment
Lactate/base deficit
TXA
Inhibits plasminogen activation
DCO lactate marker
>2.5 mmol/L
DCO coagulopathy
Platelets <70,000 + abnormal D-dimer
DCO hypothermia
<32°C
Inflammatory peak
2–5 days
Temporary fixation
External fixation
EAC timing
Within 36 h if adequately resuscitated
EAC lactate
<4 mmol/L
EAC pH
>7.25
EAC base excess
≥ about −5.5 mmol/L
Pelvic volume increased
Binder/sheet
Persistent pelvic bleeding
Angiography ± embolization
Pregnancy >20 weeks
Left lateral decubitus
Vena caval compression
Can reduce maternal CO ~30%
Fetal radiation risk
First trimester greatest
High VTE risk
Pelvis, spine, hip, lower extremity
PE in DVT
Up to 5%
FES
Hypoxia + petechiae + tachycardia
FES treatment
Supportive
ARDS
Chest trauma/multiple fractures; supportive O₂/ventilation
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