Metabolic Response to Trauma — General Surgery

Metabolic Response to Trauma MCQs: practice questions

Sample Metabolic Response to Trauma multiple-choice questions from General Surgery.

1. Which organ is a major source of acute-phase proteins during the systemic response to injury?

   • A. Glutamine
   • B. It can increase metabolic and respiratory burdens
   • C. C-reactive protein
   • D. Increased protein catabolism
   • E. Liver

2. A patient after prolonged severe trauma develops muscle wasting despite adequate calories. Which process is most responsible?

   • A. It increases
   • B. C-reactive protein
   • C. IL-1
   • D. Early control of the underlying injury and appropriate nutrition
   • E. Ongoing inflammatory and hormonal catabolism

3. Which laboratory pattern is most consistent with severe post-traumatic catabolism?

   • A. Loss of lean body mass
   • B. Ebb phase
   • C. Negative nitrogen balance
   • D. Adipose tissue triglyceride stores
   • E. Increased protein breakdown exceeds protein synthesis

4. Which metabolic change is typical after major surgery or trauma?

   • A. IL-6
   • B. Increased protein catabolism
   • C. A hypermetabolic stress response
   • D. Ebb phase
   • E. Increased catecholamines, cortisol, glucagon, and ADH

5. Which change is expected in severe inflammatory stress?

   • A. Peripheral insulin resistance
   • B. Increased hepatic synthesis of positive acute-phase proteins
   • C. Stress-induced insulin resistance
   • D. It increases
   • E. Negative nitrogen balance

6. What is the principal purpose of the hypermetabolic response after severe injury?

7. Which hormone is primarily anabolic and tends to oppose the catabolic stress response?

8. Which process supplies amino acids during severe post-traumatic catabolism?

9. Immediately after major trauma, which hormonal pattern is most characteristic of the early stress response?

10. Which clinical intervention best reduces the duration of severe post-traumatic catabolism?

11. Which nutrient is particularly important as a fuel for rapidly dividing immune cells and enterocytes?

12. Which mediator is strongly associated with fever and systemic inflammatory signaling after tissue injury?

13. Which endocrine change promotes lipolysis after major injury?

14. What happens to gluconeogenesis during severe trauma?

15. What is the typical direction of glucose metabolism during the acute stress response?

16. Which acute-phase protein generally increases after major tissue injury?

17. Which substrate is preferentially used by the brain during normal fasting before prolonged starvation?

18. Which phase of the classic response to injury is associated with increased sympathetic activity and metabolic expenditure?

19. Why may serum albumin fall after major trauma even without severe malnutrition?

20. Which physiologic response helps preserve circulating glucose for vital organs during stress?

21. What happens to resting energy expenditure after major trauma?

22. Why does urinary nitrogen increase after major injury?

23. A patient with severe burns develops increased oxygen consumption and tachycardia. This is best described as

24. A postoperative patient has hyperglycemia despite no history of diabetes. The most likely mechanism is

25. The initial low-output period immediately after major trauma is often called the

26. Which process replenishes hepatic glucose stores after a meal but is generally suppressed during acute trauma?

27. Which finding suggests persistent catabolism in a critically ill surgical patient?

28. What is the major source of circulating free fatty acids during fasting and stress?

29. Which cytokine is especially important in stimulating the hepatic acute-phase response?

30. Why is excessive overfeeding undesirable in critically ill surgical patients?