Deck 10: Abdominal Emergencies

Question 1

Which of the following refers to ecchymosis in the flanks?

A) Kehr's sign
B) Cullen's sign
C) Turner's sign
D) Bank's sign

Answer 1

C

Question 2

Which of the following are indications on plain x-ray of an enlarged spleen?

A) Displacement of the stomach
B) Displacement of the left transverse colon
C) Displacement of the small bowel loops
D) Displacement of the left kidney
E) All of the above

Answer 2

E

Question 3

Ballone sign is _________.

A) fixed dullness in the left flank
B) shifting dullness in the right flank
C) fixed dullness in the left flank and shifting dullness in the right flank
D) fixed dullness in the right flank and shifting dullness in the left flank

Answer 3

C

Question 4

As part of the history portion of your assessment, you decide to ask the patient if he has any pain associated with coughing, laughing, and general movement. Is this a necessary question to ask your patient during his assessment?

A) Yes, because these movements and activities may exacerbate the pain
B) Yes, because pain with these movements could be indicative of peritonitis
C) No, because there is little relationship between movement and pain associated with abdominal injuries
D) A & B

Question 5

Which of the following should be performed during the observation portion of an abdominal assessment?

A) Check for abdominal distention.
B) Identify location of surgical scars.
C) Provide abdominal splinting.
D) All of the above

Question 6

Treatment of an abdominal wall contusion or hematoma should be treated with which of the following?

A) Ice to reduce bleeding
B) Padding for protection
C) Continued observation to rule out severe intra-abdominal injury
D) Placing the athlete in a relaxed and flexed posture to reduce tension on the tissues
E) All of the above

Question 7

Auscultation for bowel sounds is critically important when dealing with acute injuries, because hydration and electrolyte imbalance may alter bowel sounds.

A) True
B) False
C) Cannot be determined from the information provided

Question 8

When diagnosing splenic injuries, presentation of the injury may be delayed because of bleeding contained in the capsule. Delayed rupture of a splenic injury, although an important concern, is a very uncommon complication.

A) Both statements are true.
B) Only the first statement is true.
C) Only the second statement is true.
D) Both statements are false.

Question 9

In order to identify whether or not a patient is experiencing circulatory collapse, vital signs should be monitored __________.

A) only during the initial physical exam
B) prior to and after completion of transport to the hospital
C) at set intervals, over a set period of time
D) None of the above

Question 10

Which of the following refers to ecchymosis in the periumbilical area?

A) Kehr's sign
B) Cullen's sign
C) Turner's sign
D) Bank's sign

Question 11

One of your athletes comes over to you during the second half of a game complaining of having been struck in the abdomen. Initially, the athlete was having difficulty breathing. Those signs and symptoms have subsided and you decide to send him back into the game. Following the match, the athlete begins to complain of discomfort in the abdomen. Which of the following might explain the discomfort?

A) Hollow organ injury
B) Solid organ injury
C) Hematoma of the rectus abdominus
D) All of the above
E) A & B

Question 12

Differentiating between benign injuries and injuries that require transport to a hospital can often be challenging. Abdominal injuries are infrequent, and the resulting lack of experience in evaluating them becomes a problem in their management.

A) Both statements are true.
B) Only the first statement is true.
C) Both statements are false.
D) Only the second statement is true.

Question 13

In the general population, which of the following can often mask an abdominal injury?

A) Head injury
B) Orthopedic injury
C) Medications
D) Ergogenic aids
E) All of the above

Question 14

The occurrence rate of liver injuries is extremely high in sports.

Question 15

Which of the following should be identified with respect to pain during the history portion of your evaluation?

A) Description of pain
B) Location of pain
C) Quality of pain
D) Progression of pain
E) All of the above

Question 16

What percentage of rib fractures on the left side of the body involves hepatic injuries?

A) 5%
B) 10%
C) 20%
D) 3%

Question 17

Deceleration injuries are typically involved with which of these organs?

A) Liver
B) Spleen
C) Kidneys
D) Abdominal viscera
E) All of the above

Question 18

Which of the following are signs and symptoms initially observed in patients with splenic injury?

A) Fainting
B) Dizziness
C) Weakness
D) Fainting and dizziness
E) Fainting, dizziness, and weakness

Question 19

Splenic injuries are often associated with rib fractures. What percentage of rib fractures on the right side of the body involves injuries to the spleen?

A) 5%
B) 10%
C) 20%
D) 3%

Question 20

Injuries to this region result in the "wind being knocked out" of the person.

A) Lower abdomen
B) Epigastrium
C) Lumbar plexus
D) Endogastrium

Question 21

Marathon pancreatitis is a rare condition. Which of the following are not typically linked to these cases?

A) Abdominal pain during a race
B) Abdominal pain that subsides following a race
C) Dehydration
D) Ischemia

Question 22

Which of the following are major risk factors associated with an ectopic pregnancy?

A) Pelvic inflammatory disease
B) Fallopian tube damage
C) Prior ectopic pregnancy
D) All of the above

Question 23

Which of the following has been labeled a rare injury associated with martial arts trauma? This injury often presents with pain in the flank and microscopic hematuria.

A) Renal vein thrombosis
B) Femoral vein thrombosis
C) Renal artery thrombosis
D) Obturator vein thrombosis

Question 24

A patient presents to you complaining of right upper quadrant tenderness following blunt trauma to the same region. Which of the following injuries might you suspect?

A) Kidney injury
B) Liver injury
C) Spleen injury
D) Small bowel injury

Question 25

When considering blunt trauma injuries, it is not uncommon for other abdominal structures to be injured __________ of the time.

A) 4% to 15%
B) 8% to 20%
C) 2% to 5%
D) 15% to 23%

Question 26

An athlete comes to you complaining of pain in her flank and hematuria. What condition do you suspect?

A) Liver injury
B) Kidney injury
C) Pancreatic injury
D) Renal injury

Question 27

Which of the following signs and symptoms may be present in a patient with an ectopic pregnancy?

A) Hypertension
B) Reduced pulse rate
C) Reduced abdominal tension
D) Hypotension

Question 28

Which of the following are signs and symptoms of appendicitis?

A) Right lower abdominal pain
B) Abdominal rigidity
C) Rebound tenderness
D) Pain aggravated with movement and coughing
E) All of the above

Question 29

When considering the treatment and management of hematuria, which of the following statements is not true?

A) It will likely resolve with rest.
B) In cases of suspected trauma, it should be treated with repeated or serial evaluations.
C) Magnetic resonance imaging (MRI) is the primary choice for imaging the injured area.
D) Repeated urinalysis may be required to determine if hematuria is sports or trauma related.

Question 30

Which of the following abdominal injuries have been associated with marathon running?

A) Ruptured omentum adhesions from previous surgery
B) Pubic symphysis staphylococcal infections
C) Marathon pancreatitis
D) Omental infarctions
E) All of the above

Question 31

Injury to the liver is often the result of a ___________.

A) direct blow to the upper right quadrant
B) direct blow to the left upper right quadrant
C) deceleration injury that lacerates the liver's capsule
D) A & C
E) B & C

Question 32

_________ is the implantation of a fertilized ovum outside of the endometrial cavity.

A) Ectopic pregnancy
B) Endotopic pregnancy
C) Premature pregnancy
D) Ectopic delivery

Question 33

Diagnosis of pancreatic injuries involves __________.

A) laboratory testing of serum levels
B) a computerized tomography (CT) scan to determine presence of lacerations
C) open exploratory surgery to determine the extent of the injury
D) A & C
E) A & B

Question 34

Which of the following is the most common abdominal injury in sports?

A) Liver injury
B) Kidney injury
C) Pancreatic injury
D) Renal injury