Trauma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Trauma

Sample item

A motorcyclist has an unstable pelvic fracture after a crash, with blood pressure 75/40 mmHg and a distended, tender pelvic region. FAST scan is negative. Which immediate measure should be taken along with resuscitation?

ASpring the pelvis to confirm instabilityBLog-roll repeatedly to examine the backCApply a pelvic binder or sheet at the level of the greater trochantersDInsert a urinary catheter before any other step

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Apply a pelvic binder or sheet at the level of the greater trochanters

Haemodynamically unstable pelvic fractures bleed mostly from venous plexuses and cancellous bone. A pelvic binder reduces pelvic volume and tamponades bleeding and is applied at the greater trochanters. Subsequent options include preperitoneal packing, angioembolisation and external fixation, with massive transfusion as needed.

Option by option

A. Spring the pelvis to confirm instability
Springing the pelvis can dislodge clots and is discouraged.
B. Log-roll repeatedly to examine the back
Repeated manipulation can dislodge clots and worsen haemorrhage.
C. Apply a pelvic binder or sheet at the level of the greater trochanters (correct)
Correct. A binder reduces pelvic volume and controls venous bleeding.
D. Insert a urinary catheter before any other step
Catheterisation should wait until urethral injury is excluded, and it does not control bleeding.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Apply a pelvic binder or sheet at the level of the greater trochanters. Haemodynamically unstable pelvic fractures bleed mostly from venous plexuses and cancellous bone.

Why is "Spring the pelvis to confirm instability" not the answer?

Springing the pelvis can dislodge clots and is discouraged.

Why is "Log-roll repeatedly to examine the back" not the answer?

Repeated manipulation can dislodge clots and worsen haemorrhage.

Why is "Insert a urinary catheter before any other step" not the answer?

Catheterisation should wait until urethral injury is excluded, and it does not control bleeding.

What concept does this question test?

It tests Trauma in General Surgery. A pelvic binder reduces pelvic volume and tamponades bleeding and is applied at the greater trochanters. Subsequent options include preperitoneal packing, angioembolisation and external fixation, with massive transfusion as needed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.