Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine--->Spinal Cord Injury
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Question 1#Print Question

A 27-year-old male was brought to the ICU following a motorcycle crash resulting in bilateral open femur fractures, grade IV splenic laceration, and traumatic spinal cord transection at T3.

Which of the following is NOT an expected disease-related physiological change?

a. Decreased systemic vascular resistance
b. Hypothermia
c. Increased vital capacity (VC)
d. Bradycardia

Question 2#Print Question

A 17-year-old football player presents to the ED with acute onset paraplegia after colliding head-on with another player during a training session. He is awake, alert, and oriented; has stable hemodynamics; and is in no respiratory distress with an oxygen saturation of 100% on room air. Neurological examination reveals lack of sensation below T8 and muscle weakness involving all flexors and extensors. CT scan and MRI examination of the spinal cord is negative for any acute pathology. Over the course of next few hours, his motor strength starts improving.

What would be the next course of treatment?

a. Steroids
b. EMG
c. Operative intervention
d. Close observation

Question 3#Print Question

Which of the following injuries is LEAST likely to result in spine instability?

a. A 78-year-old male brought to the ED after a 70-pound box of books fell on his head at the library
b. A 34-year-old NASCAR driver flown in as a level 1 trauma after a being involved in a head on collision at 120 miles per hour
c. A 57-year-old female who jumped out of a 7th story window after her curling iron caught on fire and is transferred from outside hospital with bilateral calcaneus fractures
d. A 18-year-old male involved in a car theft found to have multiple gunshot wounds to his lower back with exit wounds in close proximity to lumbar spine

Question 4#Print Question

A 88-year-old female presents to the ED after tripping over her cat and landing on her back. She sustains injury to her cervical spinal cord, which is immobilized with a cervical collar, and she is admitted to the ICU.

Which of the following interventions are more likely to improve her neurological outcome?

a. Maintaining systolic blood pressure (SBP) >120 mm Hg
b. Administering intravenous methylprednisolone
c. Maintaining mean arterial pressure (MAP) >85 mm Hg
d. Maintaining her central venous pressure (CVP) > 20 cm H2O
e. None of the above

Question 5#Print Question

A 40-year-old male is admitted to the ICU after being stabbed in the back during a bar fight. Neurological examination reveals loss of all sensation at the T8 level, loss of proprioception and vibration below T8 on one side, and loss of pain and temperature sensation below T8 on the other side. Motor strength is impaired on the same side as loss of proprioception and vibration.

Which of the following syndrome best describes the findings on neurological examination in this patient?

a. Brown-Sequard syndrome (BSS)
b. Central cord syndrome
c. Anterior cord syndrome
d. Complete spinal cord injury (SCI)

Category: Critical Care Medicine--->Spinal Cord Injury
Page: 1 of 1