Emergency Medicine

Question 1

Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal sx

Answer 1

Antipsychotics (neuroleptic malignant syndrome)

Question 2

Side effects of corticosteroids

Answer 2

Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies

Question 3

Treatment for DTs

Answer 3

Benzodiazepines

Question 4

Tx for acetaminophen overdose

Answer 4

N-acetylcysteine

Question 5

Tx for opioid overdose

Answer 5

Naloxone

Question 6

Tx for benzodiazepine overdose

Answer 6

Flumazenil

Question 7

Tx for neuroleptic malignant syndrome and malignant hyperthermia

Answer 7

Dantrolene

Question 8

Tx for malignant hypertension

Answer 8

Nitroprusside

Question 9

Tx of atrial fibrillation

Answer 9

Rate control, rhythm conversion, and anticoagulation

Question 10

Tx of supraventricular tachycardia

Answer 10

If stable, rate control w/ carotid massage or other vagal stimulation; if unsuccessful, consider adenosine

Question 11

Causes of drug-induced SLE

Answer 11

INH, penicillamine, hydralazine, procainamide, chlorpromazine, methyldopa, quinidine

Question 12

Macrocytic, megaloblastic anemia w/ neurologic sx

Answer 12

B12 deficiency

Question 13

Macrocytic, megaloblastic anemia w/o neurologic sx

Answer 13

Folate deficiency

Question 14

A burn pt presents w/ cherry-red, flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Tx?

Answer 14

Treat CO poisoning with 100% O2 or with hyperbaric O2 if poisoning is severe or the pt is pregnant

Question 15

Blood in the urethral meatus or high-riding prostate

Answer 15

Bladder rupture or urethral injury

Question 16

Test to r/o urethral injury

Answer 16

Retrograde cystourethrogram

Question 17

Radiographic evidence of aortic disruption or dissection

Answer 17

Widened meiastinum (>8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus

Question 18

The most common organism in burn-related infections

Answer 18

Pseudomonas

Question 19

Method of calculating fluid repletion in burn patients

Answer 19

Parkland formula: 24-hour fluids = 4 x kg x % BSA

Question 20

Acceptable urine output in a trauma patient

Answer 20

50 cc/hr

Question 21

Acceptable urine output in a stable patient

Answer 21

30 cc/hr

Question 22

Signs of neurogenic shock

Answer 22

Hypotension and bradycardia

Question 23

Signs of increased ICP (Cushing’s triad)

Answer 23

Hypertension, bradycardia, and abnormal respirations

Question 24

Decreased CO, decreased PCWP, Increased peripheral vascular resistance (PVR)

Answer 24

Hypovolemic shock

Question 25

Decreased CO, Increased PCWP, Increased PVR

Answer 25

Cardiogenic (or obstructive) shock

Question 26

Increased CO, Decreased PCWP, Decreased PVR

Answer 26

Septic or anaphylactic shock

Question 27

Tx of septic shock

Answer 27

Fluids and abx

Question 28

Tx of cardiogenic shock

Answer 28

Identify cause; pressors (eg, dopamine)

Question 29

Tx of hypovolemic shock

Answer 29

Identify cause; fluid and blood repletion

Question 30

Tx of anaphylactic shock

Answer 30

Diphenhydramine or epinephrine 1:1000

Question 31

Supportive tx for ARDS

Answer 31

Continuous positive airway pressure

Question 32

Signs of air embolism

Answer 32

A patient w/ chest trauma who was previously stable suddenly dies

Question 33

Absent breath sounds, dullness to percussion, shock, flat neck veins

Answer 33

Massive hemothorax

Question 34

Absent breath sounds, tracheal deviation, shock, distended neck veins

Answer 34

Tension pneumothorax

Question 35

Tx for blunt or penetrating abdominal trauma in hemodynamically unstable pts

Answer 35

Immediate exploratory laparotomy

Question 36

Increased ICP in alcoholics or the elderly following head trauma. Can be acute or chronic; crescent shape on CT

Answer 36

Subdural hematoma

Question 37

Head trauma w/ immediate loss of consciousness followed by a lucid interval and then rapid deterioration. Convex shape on CT

Answer 37

Epidural hematoma