Multisystem Trauma and Shock Flashcards

A trauma patient presents with hypotension, jugular venous distention, and muffled heart sounds. Which condition is most likely?

Answer: Cardiac tamponade

Beck's triad (hypotension, JVD, muffled heart sounds) is the classic presentation of cardiac tamponade.

What is the earliest reliable sign of compensated shock in a young trauma patient?

Answer: Tachycardia

Tachycardia is an early compensatory response, while hypotension is a late and ominous sign.

Which class of hemorrhagic shock corresponds to a 30-40% blood volume loss?

Answer: Class III

Class III hemorrhage involves 30-40% blood loss with marked tachycardia, hypotension, and altered mental status.

A patient with a femur fracture develops sudden dyspnea, petechiae, and confusion 24-48 hours after injury. What is the likely cause?

Answer: Fat embolism syndrome

Fat embolism syndrome classically presents with the triad of respiratory distress, neurologic changes, and petechial rash after long bone fracture.

What is the recommended target for permissive hypotension in an actively bleeding trauma patient without head injury?

Answer: SBP 80-90 mmHg

Permissive hypotension targets an SBP of approximately 80-90 mmHg to limit clot disruption until surgical control is achieved.

Which laboratory finding best reflects the adequacy of tissue perfusion in shock?

Answer: Lactate

Elevated serum lactate indicates anaerobic metabolism and inadequate tissue oxygen delivery, a key marker of shock severity.

In neurogenic shock from a spinal cord injury, which combination of findings is expected?

Answer: Hypotension with bradycardia

Neurogenic shock causes hypotension with bradycardia due to loss of sympathetic tone and unopposed vagal activity.