# AMC MCQ Trauma Questions: 10 Free Practice MCQs

> 10 free AMC MCQ trauma questions with answers and explanations, from a bank of 25 trauma questions. Try them now, no sign up.

Canonical: https://medhub.one/practice/amc-mcq/trauma
Last updated: 2026-10-31

Trauma questions follow the primary survey in order. The AMC MCQ expects catastrophic bleeding control, airway and breathing assessment, and recognition of shock that the visible injury does not explain. Head injury, chest trauma, pelvic fracture and the older patient on an anticoagulant all appear. The marked answer follows the trauma system and avoids imaging before resuscitation.

## Where candidates lose marks

* Missing a tension pneumothorax or tamponade because imaging was arranged first.
* Forgetting major haemorrhage activation and tranexamic acid in a shocked patient.
* Failing to reverse anticoagulation in a head injured patient.
* Moving a patient before the cervical spine has been considered.

**Guideline to follow:** The AMC MCQ follows the ATLS approach, the state trauma system guidelines and the Australian and New Zealand guidance on major haemorrhage and head injury.

Ten AMC MCQ-style trauma questions with the answer and the reasoning behind it. They come from the AU.med bank, which has 25 trauma questions and many more across every topic.

[Free timed mock exam](https://medhub.one/practice/amc-mcq/mock)

1. 1 / 10  
A 40-year-old gardener presents with a deep, soil-contaminated laceration on his hand from a rusty spade. He has completed a primary course of tetanus vaccinations in childhood but has not received a booster in the last 15 years.  
What tetanus prophylaxis is recommended for this patient?  
Show answer

**Answer: A.** Administer a single dose of dTpa (tetanus-diphtheria-pertussis) vaccine.

**Why:** For tetanus-prone wounds (dirty, contaminated, deep), a booster dose of dTpa or dT is recommended if the last dose was more than 5 years ago. Tetanus Immunoglobulin (TIG) is only required if the patient has a history of incomplete or uncertain primary immunisation (<3 doses).

  * **B.** TIG is only required for tetanus-prone wounds in individuals who are unvaccinated.
  * **C.** Primary course does not provide lifelong immunity; a booster is required after 5 years.
  * **D.** Antibiotics do not replace immunisation for tetanus prevention.  
Sources: Australian Immunisation Handbook
2. 2 / 10  
A 45-year-old man is brought in after a high speed crash with a Glasgow Coma Score of 6 and a large scalp laceration. His blood pressure is 78/50 mmHg and his heart rate is 128 beats per minute.  
What is the most likely explanation for his hypotension?  
Show answer

**Answer: B.** Occult haemorrhage such as into the chest, abdomen, pelvis or from a long bone

**Why:** Head injury alone does not cause hypotension except uncommonly as a terminal event from medullary failure, so hypotension in a head injured patient should prompt a search for another cause such as bleeding into the chest, abdomen or pelvis, a long bone fracture, or a spinal injury. The combination of hypotension with tachycardia points to hypovolaemia rather than a neurogenic cause, which would produce bradycardia. Raised intracranial pressure classically produces hypertension with bradycardia, the opposite pattern to this man, so an intracranial explanation would be misleading.

  * **A.** Head injury alone does not cause hypotension except as a terminal event, so another source of blood loss must be sought.
  * **C.** Raised intracranial pressure produces hypertension with bradycardia rather than hypotension with tachycardia.
  * **D.** Neurogenic shock causes bradycardia, whereas this man is tachycardic, pointing instead to blood loss.  
Sources: Neurosurgical Society of Australasia. The Management of Acute Neurotrauma in Rural and Remote Locations, 3rd ed, 2009 (published by the Royal Australasian College of Surgeons).
3. 3 / 10  
A 7-year-old boy is hit by a car and arrives in the emergency department with a systolic blood pressure below the age appropriate range, a distended abdomen and an open thigh wound with active bleeding. He is moaning but has a patent airway and adequate ventilation.  
According to the primary survey, which problem should be addressed first?  
Show answer

**Answer: C.** Control the catastrophic external haemorrhage from the thigh

**Why:** The paediatric primary survey uses an extended sequence beginning with catastrophic haemorrhage before airway, breathing, circulation, disability and exposure. Control of exsanguinating external haemorrhage is the first priority, using direct pressure and a tourniquet for a life threatening limb wound, along with a pelvic binder for a suspected pelvic fracture with haemodynamic compromise. The airway is patent and ventilation is adequate, and imaging or catheterisation must not delay haemorrhage control.

  * **A.** The airway is patent and ventilation is adequate, so the immediate priority is the life threatening bleeding rather than intubation.
  * **B.** Imaging must not delay control of haemorrhage, and the extended primary survey places catastrophic bleeding first.
  * **D.** Urinary catheterisation is considered later in the resuscitation and does not address the exsanguinating wound.  
Sources: RCH Clinical Practice Guideline: Trauma - primary survey (The Royal Children's Hospital Melbourne, last updated January 2022)
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5. 4 / 10  
A 28-year-old male with a mechanical heart valve on long-term warfarin therapy presents after a minor head injury. On arrival his GCS is 14 with no focal neurological deficits.  
According to Canadian CT Head Rules (applied in Australian ED guidelines), what is the appropriate management?  
Show answer

**Answer: C.** Immediate CT brain, as anticoagulation is a mandatory indication

**Why:** Under validated head injury guidelines (such as the Canadian CT Head Rule and Australian Emergency Care guidelines), any history of bleeding diathesis or active anticoagulation (e.g., warfarin, DOACs) is a high-risk criterion requiring an immediate CT brain, even with a GCS of 14-15\. Observation alone or waiting for neurological decline or recurrent vomiting dangerous delays diagnosis of intracranial bleeding.

  * **A.** Incorrect. Anticoagulation or bleeding diathesis is a high-risk inclusion criterion requiring an urgent CT brain regardless of mild initial GCS.
  * **B.** Incorrect. While vomiting ≥2 episodes is a CT criterion in non-anticoagulated patients, any bleeding diathesis independently warrants an immediate CT scan.
  * **D.** Incorrect. Waiting for neurological deterioration risks catastrophic expansion of an intracranial haematoma before intervention.  
Sources: NSW Health Clinical Policy: Traumatic Brain Injury Management; Therapeutic Guidelines: Emergency
6. 5 / 10  
A 29-year-old man has an acute cervical spinal cord injury after a diving accident. He is being managed in a rural hospital before transfer, and a colleague asks whether a course of high-dose corticosteroids should be started.  
What is the recommended approach?  
Show answer

**Answer: D.** Do not give corticosteroids

**Why:** The primary hospital care of a patient with spinal injury continues immobilisation, maintains airway, oxygenation and blood pressure, and includes a detailed neurological, sensory and autonomic assessment. The RACS guideline places methylprednisolone in this management sequence with the explicit statement that it is not recommended, so corticosteroids are withheld. Nasogastric and urinary catheters are used, normothermia is maintained, and two-hourly lifting or log rolling prevents pressure injury, with attention to associated head, chest and abdominal injuries.

  * **A.** The RACS neurotrauma guideline states that methylprednisolone is not recommended in the management of acute spinal injury.
  * **B.** Dexamethasone is not part of the guideline's management of acute spinal cord injury and would expose the patient to unnecessary harm.
  * **C.** The recommendation applies irrespective of whether the cord injury is complete or incomplete.  
Sources: Royal Australasian College of Surgeons. The Management of Acute Neurotrauma in Rural and Remote Locations. RACS, version 2, 2009.
7. 6 / 10  
A 72-year-old woman on warfarin for atrial fibrillation presents after a minor fall. She has a gradual onset of confusion and mild left-sided weakness over the last 3 weeks. CT brain shows a crescent-shaped, hypodense collection crossing suture lines. Her INR is 2.8.  
What is the most appropriate next step in management?  
Show answer

**Answer: D.** Refer to neurosurgery for evaluation and reverse anticoagulation with prothrombin complex concentrate.

**Why:** The patient has a symptomatic chronic subdural haematoma (crescentric, hypodense collection crossing suture lines). Management involves reversing the warfarin-induced coagulopathy with prothrombin complex concentrate (PCC) and Vitamin K, and referring to neurosurgery for evaluation for surgical evacuation (burr holes or craniotomy).

  * **A.** Burr holes are reserved for rapid deterioration/herniation, not subacute stable haematomas.
  * **B.** Symptomatic subdural haematomas require surgical evacuation or close monitoring.
  * **C.** CT is diagnostic and reversing coagulopathy must not be delayed in symptomatic haemorrhage.  
Sources: RACS Neurosurgery Guidelines
8. 7 / 10  
A 24-year-old male motorcyclist sustains a closed mid-shaft tibia-fibula fracture. The leg is splinted. Six hours later, he reports severe, escalating pain in his calf that is unresponsive to intravenous morphine. On examination, the calf is tense, and there is excruciating pain on passive extension of the toes. Distal pulses are palpable.  
What is the most appropriate immediate management?  
Show answer

**Answer: D.** Emergency surgical fasciotomy of the leg compartments.

**Why:** Acute compartment syndrome is a surgical emergency. The presence of pulses does not exclude the diagnosis as perfusion pressures can still be severely compromised. Definitive treatment is emergency surgical decompression via fasciotomy of all four compartments.

  * **A.** Elevation reduces arterial pressure and perfusion, worsening ischaemia in compartment syndrome.
  * **B.** Pulses are often intact in compartment syndrome; ultrasound delays surgery.
  * **C.** Delaying intervention leads to irreversible muscle and nerve damage.  
Sources: RACS Trauma Guidelines
9. 8 / 10  
A 40-year-old man is in cardiac arrest after a fall from a height with severe chest and pelvic injuries. The monitor shows a narrow complex rhythm at 60 per minute with no palpable pulse.  
What is the most likely rhythm and the appropriate focus of management?  
Show answer

**Answer: B.** Pulseless electrical activity, with early correction of reversible causes

**Why:** Traumatic cardiac arrest usually presents with a non-shockable rhythm, most often pulseless electrical activity, because it is commonly driven by hypovolaemia from haemorrhage, along with hypoxia, tension pneumothorax and tamponade. Management therefore focuses on early and aggressive correction of these reversible causes, using the two Hs and two Ts of traumatic arrest, alongside haemorrhage control and chest decompression. Defibrillation is reserved for ventricular fibrillation or pulseless ventricular tachycardia, and asystole describes absent electrical activity, so neither fits an organised rhythm with no palpable pulse.

  * **A.** Ventricular fibrillation is a shockable rhythm and is less common in traumatic arrest than pulseless electrical activity.
  * **C.** A rhythm with no palpable pulse is pulseless electrical activity, not a monitoring error.
  * **D.** Asystole is complete absence of electrical activity, whereas organised electrical activity is present here.  
Sources: Queensland Clinical Guidelines. Traumatic injury in pregnancy. Guideline No. MN26.31-V3-R31\. Queensland Health, 2026.; ANZCOR. Guideline 11.2 Protocols for Adult Advanced Life Support, June 2024.
10. 9 / 10  
A 28-year-old male trauma patient is examined. He opens his eyes in response to a painful sternal rub, makes incomprehensible sounds, and withdraws his arm from the painful stimulus.  
What is his Glasgow Coma Scale (GCS) score?  
Show answer

**Answer: B.** GCS 8 (E2, V2, M4).

**Why:** The Glasgow Coma Scale is calculated as follows: Eye opening: to pain = 2 points. Verbal response: incomprehensible sounds (moaning) = 2 points. Motor response: flexion withdrawal from pain = 4 points. Total GCS = 2 + 2 + 4 = 8\. A GCS of 8 or less indicates a severe head injury and typically requires airway protection.

  * **A.** V3 is inappropriate words; he makes only sounds.
  * **C.** E1 is no eye opening; he opens eyes to pain.
  * **D.** E3 is to voice, M5 is localising pain.  
Sources: EMST (Early Management of Severe Trauma) Guidelines
11. 10 / 10  
A 21-year-old man is struck in the temple by a cricket ball. He was briefly unconscious, then woke up and felt completely normal. Two hours later, he develops an escalating headache, confusion, and a dilated left pupil.  
What is the most likely diagnosis and the most appropriate next step?  
Show answer

**Answer: D.** Epidural haematoma; perform an urgent non-contrast CT brain.

**Why:** The 'lucid interval' (brief unconsciousness, recovery of consciousness, then rapid neurological deterioration) is classic for an epidural haematoma, usually caused by rupture of the middle meningeal artery. The dilated ipsilateral pupil indicates uncal herniation compressing the third cranial nerve, necessitating an urgent CT brain and neurosurgical decompression.

  * **A.** Rapid deterioration with focal neurological signs is a medical emergency, not benign post-concussion syndrome.
  * **B.** Lumbar puncture is contraindicated in patients with suspected mass lesions due to the risk of brain herniation.
  * **C.** This is a traumatic brain injury with signs of raised intracranial pressure.  
Sources: RACS Neurosurgery Guidelines

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