ITLS - International Trauma Life Support Head and Spinal Trauma Questions and Answers

Question 1

A 45-year-old male is found unconscious after falling from a ladder.
His initial vital signs are BP 190/110 mmHg, HR 52 bpm, and he has irregular, gasping respirations.
His right pupil is dilated and non-reactive.
These findings are most indicative of:

Accepted Answer

Cushing's triad due to increased intracranial pressure

Answer

Spinal shock

Answer

Neurogenic shock

Answer

Decompensated hemorrhagic shock

Question 2

You are treating a 22-year-old who was stabbed in the right side of his neck. Assessment reveals paralysis and loss of position sense in his right arm and leg, with a loss of pain and temperature sensation on his left side below the injury. This pattern of deficits is most consistent with which spinal cord syndrome?

Accepted Answer

Brown-Séquard Syndrome

Answer

Anterior Cord Syndrome

Answer

Central Cord Syndrome

Answer

Cauda Equina Syndrome

Question 3

A patient involved in a high-speed collision has a suspected high thoracic spinal cord injury. Which set of vital signs is most characteristic of neurogenic shock?

Accepted Answer

BP 86/58 mmHg, HR 58 bpm, warm and dry skin

Answer

BP 80/50 mmHg, HR 130 bpm, cool and clammy skin

Answer

BP 180/100 mmHg, HR 50 bpm, irregular respirations

Answer

BP 110/70 mmHg, HR 110 bpm, pale and diaphoretic skin

Question 4

According to ITLS guidelines, which of the following patients requires the application of spinal motion restriction (SMR)?

Accepted Answer

A 60-year-old driver in a moderate-speed MVC who is intoxicated and has a distracting forearm fracture.

Answer

A 40-year-old with a gunshot wound to the abdomen who is ambulatory on scene.

Answer

A 25-year-old who fell from a standing height, is alert and oriented, and denies any neck or back pain.

Answer

A 30-year-old with an isolated stab wound to the arm with controlled bleeding.

Question 5

An elderly patient falls and strikes their chin, causing a hyperextension injury of the neck. They present with significant motor weakness in their arms and hands but are able to move their legs with near-normal strength. This clinical picture is most typical of:

Accepted Answer

Central Cord Syndrome

Answer

Brown-Séquard Syndrome

Answer

Anterior Cord Syndrome

Answer

Posterior Cord Syndrome

Question 6

When managing a patient with a severe traumatic brain injury who is showing signs of cerebral herniation (e.g., unilateral dilated pupil, posturing), what is the recommended immediate ventilation strategy according to ITLS?

Accepted Answer

Provide mild, controlled hyperventilation to a target EtCO2 of 30-35 mmHg.

Answer

Hyperventilate the patient to maintain an EtCO2 of 20-25 mmHg.

Answer

Maintain normal ventilation to achieve an EtCO2 of 35-45 mmHg.

Answer

Allow permissive hypercapnia to increase cerebral blood flow.

A 45-year-old male is found unconscious after falling from a ladder.His initial vital signs are BP 190/110 mmHg, HR 52 bpm, and he has irregular, gasping respirations.His right pupil is dilated and non-reactive.These findings are most indicative of:

A 45-year-old male is found unconscious after falling from a ladder.
His initial vital signs are BP 190/110 mmHg, HR 52 bpm, and he has irregular, gasping respirations.
His right pupil is dilated and non-reactive.
These findings are most indicative of: