CM. Specify the correct statements, relating to traumatic injuries.

A. It is the leading cause of death among people between 1 and 50 years of age
B. It takes the first place in mortality structure
C. It is the leading cause of death among people of all ages
D. It takes the second place in mortality structure
E. Men are affected by trauma two folds more often, than women
ANSWER: A, D, E

CS. About half of all deaths occur within seconds or minutes of injury and are
related to:
A. Infectious complications
B. Lacerations of the aorta, heart, and brain
C. Persistent hemorrhage
D. Multiple organ failure
E. Development of traumatic disease
ANSWER: B

CS. In patients with severe trauma the “golden hour” is called:

A. The first hour after admission of patient
B. The first hour after surgery
C. The first hour after trauma
D. The first hour after correction of shock and stabilization of hemodynamics
E. The first hour after stop of hemorrhage
ANSWER: C

CS. During the second mortality peak (first hours after injury) the percentage of
death, caused by trauma, is:
A. 20%
B. 30%
C. 40%
D. 50%
E. 60%
ANSWER: B

CM. During the first “golden hour” after severe injury by early treatment can be
prevented many of deaths, related to:
A. Injuries of the central nervous system
B. Injuries of extremities and pelvis bones
C. Multiple organ failure
D. Persistent hemorrhage
E. Infectious complications
ANSWER: A, D

CM. Which of the following factors are of main importance in biomechanics of blunt
trauma?
A. Combined (mechanical and thermal) action of etiological agent
B. Compression of tissues during impact
C. Separation of tissues along the path of the penetrating object
D. Massive external bleeding
E. Changes in speed motion of the body (acceleration or deceleration)
ANSWER: B, E

CS. The term “katatrauma” means:

A. Industrial injury
B. Car crash accident
C. Injury as a result of falling from a height
D. Sportive injury
E. Injury as a result of medical manipulation
ANSWER: C
CS. The term iatrogenic injury means:
A. Industrial injury
B. Car crash accident
C. Injury as a result of falling from a height
D. Sportive injury
E. Injury as a result of medical manipulation
ANSWER: E

CM. In accordance to character of damage agent traumas are divided into:

A. Sportive trauma
B. Psychic trauma
C. Electrical trauma
D. Mechanical trauma
E. Chemical trauma
ANSWER: B, C, D, E

CS. What type of trauma is classified as multiple?

A. Injuries of two and more organs from one anatomical system
B. Injuries caused by action of two or more etiological factors
C. Two or more injuries of one organ
D. Simultaneous injuries of organs from different anatomical systems
E. Injury of only one organ
ANSWER: A

CS. What type of trauma is classified as associated (polytrauma)?

A. Injuries of two and more organs from one anatomical system
B. Injury of only one organ
C. Two or more injuries of one organ
D. Simultaneous injuries of organs from different anatomical systems
E. Injuries caused by action of two or more etiological factors
ANSWER: D

CM. Which of the following injuries are related to isolated trauma?

A. Solitary injury of one organ
B. Multiple injuries of one organ
C. Solitary injuries of two organs from one anatomical system
D. Injuries of one isolated organ in different anatomical systems (lung, spleen,
fractured tibia)
E. Solitary injuries of two organs from different anatomical systems
ANSWER: A, B

CM. Which of the given injuries are related to associated trauma (polytrauma)?
A. Wound of the stomach, liver and spleen
B. Fracture of hip and flame burns of lower extremities
C. Rupture of spleen and ribs fractures
D. Fracture of ribs, lung injury and pneumothorax
E. Hip fracture, concussion of brain and liver injury
ANSWER: C, E

CM. Which of the following injuries are related to multiple trauma?

A. Wound of the stomach, liver and spleen
B. Fracture of hip and flame burns of lower extremities
C. Rupture of spleen and ribs fractures
D. Fracture of ribs, lung injury and pneumothorax
E. Hip fracture, concussion of brain and liver injury
ANSWER: A, D

CS. Which of the following injuries relates to multiple trauma?

A. Injuries of two and more organs from one anatomical system
B. Injuries of two and more organs from different anatomical systems
C. Multiple injuries of one organ in one anatomical system
D. Injuries caused by action of two or more traumatic factors
E. All mentioned above
ANSWER: A

CM. What periods are distinguished in traumatic disease?

A. Period of traumatic shock
B. Period of hemodynamics stabilization
C. Period of early manifestations
D. Period of late disturbances
E. Period of convalescence
ANSWER: A, C, D, E

CM. Which of the following statements characterizes the period of traumatic shock
in traumatic disease?
A. Development of dystrophic and sclerotic processes in the inner organs
B. It is caused by direct tissue damage and acute blood loss
C. It is caused by massive resorbtion into the blood stream of tissue and bacterial
toxins
D. It lasts from several hours to 2 days
E. Development of acute cardiovascular failure
ANSWER: B, D, E

CM. Which of the following statements characterizes the period of early

manifestations in traumatic disease?
A. It is caused by massive resorption of tissue and bacterial toxins into the blood
stream
B. It is caused by direct tissue damage and acute blood loss
C. It lasts from several hours to 2 days
D. It lasts from 2 to 10 days
E. High fever over 38°С
ANSWER: A, D, E

CS. In what period of traumatic disease the traumatized patient may develop an
acute toxemia and septicopyemia?
A. In the period of traumatic shock
B. In the period of early manifestations
C. In the period of late disturbances
D. In the period of convalescence
E. In the period of degenerative and atrophic changes
ANSWER: B

CM. Which of the following statements characterizes the period of late disturbances
in traumatic disease?
A. Development of dystrophic and sclerotic processes in the inner organs
B. It is caused by direct tissue damage and acute blood loss
C. It is caused by massive resorption of tissue and bacterial toxins into the blood
stream
D. Development of contractures and ankylosis
E. Development of acute cardiovascular failure
ANSWER: A, D

CS. The length of convalescence period in traumatic disease is:

A. Up to 2 days
B. From 2 to 10 days
C. From 2 to 3 weeks
D. From 1 to 3 months
E. From a few months to several years
ANSWER: E

CM. Mechanisms of primary brain injury after trauma include:

A. Damage to vessels
B. Increased intracranial pressure
C. Hypoxia
D. Disruption of brain structures
E. Altered cellular biochemical processes
ANSWER: A, D

CM. Mechanisms of secondary brain injury after trauma include:

A. Damage to vessels
B. Increased intracranial pressure
C. Hypoxia
D. Disruption of brain structures
E. Altered cellular biochemical processes
ANSWER: B, C, E

CM. What local symptoms may suggest severe head trauma (eg, fractures of the skull
base)?
A. Significant bleeding from head wound
B. Periorbital ecchymosis (“raccoon’s sign”)
C. Otorrhea
D. Ecchymosis over the mastoid process
E. Rhinorrhea
ANSWER: B, C, D, E

CM. Which of the following signs is related to general neurological symptoms after
head trauma?
A. Hyperthermia
B. Hemiparesis
C. Anisocoria
D. Headache and dizziness
E. Nausea and vomiting
ANSWER: A, D, E

CM. Which of the following signs is related to focal neurological symptoms after
head trauma?
A. Hyperthermia
B. Hemiparesis
C. Anisocoria
D. Headache and dizziness
E. Nausea and vomiting
ANSWER: B, C

CS. What is a unilateral hemiparesis in case of traumatic brain injury?

A. Loss of muscle function of arm and leg from one side of the body
B. Weakness of voluntary movements of both legs
C. Weakness of voluntary movements of arm and leg from one side of the body
D. Loss of muscle function of both legs
E. Weakness of voluntary movements of both arms
ANSWER: C

CS. What is a unilateral paralysis in case of traumatic brain injury?

A. Loss of muscle function of arm and leg from one side of the body
B. Weakness of voluntary movements of both legs
C. Weakness of voluntary movements of arm and leg from one side of the body
D. Loss of muscle function of both legs
E. Weakness of voluntary movements of both arms
ANSWER: A

CS. How is called the pupillary’s diameter difference due to traumatic brain
injury?
A. Exophthalmos
B. Mydriasis
C. Anisocoria
D. Nystagmus
E. Diplopia
ANSWER: C

CS. Glasgow scale is used to determine:

A. Grade of obesity
B. Operating risk
C. Level of consciousness
D. Severity of blood loss
E. Prognosis of burns disease
ANSWER: C

CM. Which parameters in Glasgow scale are used to determine the level of
consciousness in head trauma?
A. Eye opening
B. Pupillary’s light reflex
C. Verbal response
D. Motor response
E. Skin sensitivity
ANSWER: A, C, D

CM. Which of the following head injuries cause only general neurological symptoms?
A. Skull fractures
B. Cerebral contusion
C. Diffuse axonal injury
D. Brain concussion
E. Cerebral compression by hematoma
ANSWER: C, D

CM. Which of the following head injuries cause both general and focal neurological
symptoms?
A. Skull fractures
B. Cerebral contusion
C. Diffuse axonal injury
D. Brain concussion
E. Cerebral compression by hematoma
ANSWER: B, E

CS. Specify the mildest form of brain injury.

A. Cerebral contusion
B. Diffuse axonal injury
C. Cerebral concussion
D. Cerebral compression
E. Subdural and epidural hematoma
ANSWER: C

CM. Which type of hematoma does not lead to cerebral compression in head injury?
A. Epidural hematoma
B. Subdural hematoma
C. Subfascial hematoma
D. Intracerebral hematoma
E. Subcutaneous hematoma
ANSWER: C, E

CM. Skull fractures are divided into:

A. “Green stick” fractures
B. Basal skull fractures
C. Linear fractures
D. Open fractures
E. Depressed fractures
ANSWER: B, C, D, E

CS. Which of the given symptoms does not occur in brain concussion?
A. Bradycardia
B. Loss of consciousness
C. Headache
D. Retrograde amnesia
E. Anisocoria
ANSWER: E

CS. What is the main method of treatment for intracerebral hematomas?

A. Haemostatic therapy
B. Infusion therapy (prevention of cerebral edema)
C. Anticonvulsants
D. Surgical (craniotomy, trepanation)
E. Endovascular intervention (embolization of the bleeding vessel)
ANSWER: D

CS. In case of the chest injury subcutaneous emphysema suggests:

A. Hemothorax
B. Pneumothorax
C. Hydrothorax
D. Pyothorax
E. Ribs fractures
ANSWER: B

CS. What does the tympanic sound on percussion of the chest suggest in case of
injury?
A. Hemothorax
B. Pneumothorax
C. Hydrothorax
D. Pyothorax
E. Ribs fractures
ANSWER: B

CS. In case of trauma dullness on percussion of the chest suggests:

A. Hemothorax
B. Cardiac contusion
C. Pneumothorax
D. Rib fractures
E. Sternal fractures
ANSWER: A

CS. What treatment is recommended, if simple pneumothorax is large enough to be

seen on plain chest radiograph?
A. Thoracentesis with aspiration of air
B. Decompression of pleural cavity with a large-bore needle
C. Conservative therapy followed by radiological control
D. Tube thoracostomy
E. Thoracotomy with suturing of injured bronchus
ANSWER: D

CS. “Valve” pneumothorax is also called:

A. Simple pneumothorax
B. Open pneumothorax
C. Closed pneumothorax
D. Tension pneumothorax
E. Complicated pneumothorax
ANSWER: D

CS. What emergency curative measure is indicated in tension pneumothorax?

A. Application of occlusive dressing
B. Decompression of pleural cavity with large-bore needle
C. Thoracotomy with suturing of defect in the lung
D. Fixation of rib fragments using intraosseous or extrafocal osteosynthesis
E. Bronchoscopy with occlusion of the appropriate bronchus
ANSWER: B

CM. Open pneumothorax is characterized by:

A. Intrathoracic and ambient pressures are equilibrated, leading to collapse of the
lung
B. Incoming into the pleural cavity air cannot exit out and progressively
accumulates
C. The affected lung is completely collapsed, and mediastinum and trachea are
displaced to the opposite side
D. The presence of a large chest wall defect
E. Usually it is caused by shotgun wound
ANSWER: A, D, E

CM. Which of the following clinical signs of hemothorax does not occur in
pneumothorax?
A. Shock
B. Hyperresonance on percussion of the chest on the affected side
C. Presence of dyspnea
D. Dullness on percussion of the chest on the affected side
E. Decreased breath sounds on the side of injury
ANSWER: A, D

CS. Specify the triad of Beck in cardiac tamponade.

A. Hypotension, diffuse enlargement of heart borders, blood on pericardial
aspiration
B. Muffled heart tones, hypotension, jugular venous distention
C. High central venous pressure, diffuse enlargement of heart borders, blood on
pericardial aspiration
D. Jugular venous distention, diffuse enlargement of heart borders, blood on
pericardial aspiration
E. Muffled heart tones, hypotension, presence of wound in the central area of the
chest
ANSWER: B

CS. Unilateral dullness on percussion with appearance of peristaltic sounds over

the affected side of chest is revealed in case of:
A. Tension pneumothorax
B. Caked or clotted hemothorax
C. Esophageal injury
D. Traumatic diaphragmatic hernia
E. Traumatic rupture of intestine
ANSWER: D
CS. When is abdominal wound considered to be penetrating?
A. When the skin is damaged
B. When skin, subcutaneous tissue, aponeurosis and muscles of abdominal wall are
damaged
C. When an abdominal organ is damaged
D. When the parietal peritoneum is damaged
E. When the visceral peritoneum is damaged
ANSWER: D

CS. What is the main purpose of examination of patients with abdominal trauma?
A. To determine the general status of patient and the presence of comorbidities
B. To determine the existence of intra-abdominal injuries
C. To determine, whether the injury is blunt or penetrating
D. To determine, what specific intra-abdominal organ is injured
E. To determine the exact circumstances of injury
ANSWER: B