Emergency medicine

Question 1

)Class of drugs that may cause syndrome of muschle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms

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

Treatment for acetaminophen overdose

Answer 4

N-acetylcysteine

Question 5

Treatment for opioid overdose

Answer 5

Naloxone

Question 6

Treatment for benzodiazepine overdose

Answer 6

Flumazenil (monitor for withdrawal and seizures)

Question 7

Treatment for neuroleptic malignant syndrome and malignant hyperthermia

Answer 7

Dantrolene

Question 8

Treatment of atrial fibrilation

Answer 8

Rate control rhythm conversion, and anticoagulation

Question 9

Treatment of supraventricular tachycardia

Answer 9

If stable, rate control with carotid massage or other vagal stimulation, if unsuccessful, consider adenosine

Question 10

Cause of drug-induced SLE

Answer 10

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

Question 11

Macrocytic megaloblastic anemia with neurologic symproms

Answer 11

B12 deficiency

Question 12

Macrocytic megaloblastic anemia without neurologic symptoms

Answer 12

Folate deficiency

Question 13

A burn patient presents with cherrry-red, flushed skin and coma. SaO2 is normal but carboxygemoglobin is elevated. Treatment?

Answer 13

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

Question 14

Test to rule out urethral infury

Answer 14

Retrograde cystourethrogram

Question 15

Radiographic evidence of aortic disruption or dissecction

Answer 15

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

Question 16

Radiographic indications for surgery in patients with acute abdomen

Answer 16

Free air under the diaphragm, extravasation of contrast, severe bowel distnetion, space-occupying lesion (CT), mesenteric occlusion (angiography)

Question 17

The most common organism in burn-related infections

Answer 17

Pseudomonas

Question 18

Method of calculating fluid repletion in burn patients

Answer 18

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

Question 19

Acceptable urine output in a trauma patient

Answer 19

50cc/hour

Question 20

Acceptable urine output in a stable patient

Answer 20

30cc/hour

Question 21

Signs of neurogenic shock

Answer 21

Hypotension and bradycardia

Question 22

Sign of elevated ICP (Cushing triad)

Answer 22

Hypertension, bradycardia and abnormal respirations

Question 23

Lowered CO2, lowered PCWP, elevated peripheral vascular resitance (PVR)

Answer 23

Hypovolemic shock

Question 24

Lowered CO2, elevated PCWP, elevated PVR

Answer 24

Cardiogenic (or obstuctive) shock

Question 25

elevated CO2, lowered PCWP and lowered PVR

Answer 25

Distributive (eg, septic or anaphylactic) shock

Question 26

Treatment of septic shock

Answer 26

Fluids and antibiotics

Question 27

Treatment of cardiogenic shock

Answer 27

Identify cause; inotropes (eg, dopamine)

Question 28

Treatment of hypovolemic shock

Answer 28

Identify cause; fluid and blood repletion

Question 29

Supportive treatment for ARDS

Answer 29

Low tidal volume ventilation

Question 30

Signs of air emboism

Answer 30

A patient with chest trauma who was previously stable suddenly dies

Question 31

Signs of cardiac tamponade

Answer 31

Distended neck veins, hypotension, diminished heart sounds (Beck triad); pulsus paradoxus

Question 32

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

Answer 32

Massive hemothorax