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Hamilton 2020 Questions > Emergency Medicine > Flashcards

Emergency Medicine Flashcards

1
Q

A 17 y.o. male ingested an unknown quantity of Jimson weed. Which of the following is most consistent with his toxidrome?

  1. Hyperthermia, dry skin, mydriasis, tachycardia
  2. Hyperthermia, diaphoresis, mydriasis, tachycardia
  3. Hyperthermia, dry skin, miosis, tachycardia
  4. Hypothermia, diaphoresis, miosis, tachycardia
A
  1. Hyperthermia, dry skin, mydriasis, tachycardia
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2
Q

A 16 y.o. female presents with Temp 38.6, HR 156, RR 28, pupils 5 mm, and diaphoresis. She is alert but not agitated. What is the most likely toxidrome?

  1. Serotonin syndrome
  2. Lomotil ingestion
  3. MDMA (Ecstasy) ingestion
  4. Amitryptyline (tricyclic antidepressant)
A
  1. MDMA (Ecstasy) ingestion
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3
Q

A 16 y.o. male ingested an over-the -counter medication “to get high”. He presents with agonal respirations, somnolescence, prolonged QT and QRS. What’s the most likely agent?

  1. Loperamide (lmodium)
  2. Amitryptyline
  3. Diphenhydramine (Benadryl)
  4. Cough syrup containing dextromethorphan
A
  1. Loperamide (lmodium)
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4
Q

A 10 y.o. male ingested 25 tablets of extra strength Tylenol an unknown time ago. He refuses activated charcoal. The most reasonable course of action is?

  1. Comply with his refusal
  2. Insert an NG tube and deliver charcoal
  3. Await a 4-hour acetaminophen level before starting NAC
  4. Perform gastric lavage following endotracheal intubation
A
  1. Comply with his refusal
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5
Q

A 16 y.o. male undergoing a dental procedure presents in status epilepticus after receiving local anesthetic. How would you manage his condition?

  1. Lorazepam followed by phenytoin load
  2. Lorazepam and intralipid
  3. Lorazepam followed by nephrology consult for consideration of hemodialysis
  4. Midazolam followed by phenbarbital load
A
  1. Lorazepam and intralipid
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6
Q

A 14 y.o. female ingested 15 tablets of her own diabetes medication. She presents with a metabolic acidosis and bedside glucose of 5.6. What is the most likely agent ingested?

  1. Glyburide
  2. Insulin
  3. Metformin
  4. Roziglitazone
A
  1. Metformin
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7
Q

A 16 y.o pregnant female has ingested 20 tablets of ES Tylenol 8 hours ago. She is stable and has no symptoms. The most reasonable next step is?

  1. Start IV NAC protocol immediately
  2. Await an APAP level and start NAC based on Rumack-Matthew nomogram
  3. Start PO NAC immediately following activated charcoal
  4. Ensure viable pregnancy and arrange for hemodialysis
A
  1. Start IV NAC protocol immediately
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8
Q

A 13 y.o. male has ingested 20 tablets of Advil. He is vomiting and complains of ringing in his ears. The most useful investigation is?

  1. Flat plate abdominal xray
  2. Serum ibuprofen level
  3. Serum creatinine
  4. Serum acetaminophen level
A
  1. Serum acetaminophen level
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9
Q

A 3 y.o. female accidentally ingested methyl salicylate. She presents tachypnic and seizing with an elevated plasma salicylate. What is the preferred therapeutic modality?

  1. Early endotracheal intubation
  2. Early and aggressive serum alkalinization
  3. Start IV phenytoin infusion
  4. Hemodialysis
A
  1. Hemodialysis

It’s too late for #2

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10
Q

A 3 year old female presents inebriated after an unknown ingestion. Her capillary gas is normal but her osmolar gap is 26 mOsm and her serum ketones are elevated. Which of the following was most likely ingested?

  1. Ethylene glycol
  2. Isopropyl alcohol
  3. Ethanol
  4. Methanol
A
  1. Isopropyl alcohol
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11
Q

A 2 y.o. F presents with ataxia after playing in the garage. Her parents noticed the smell on antifreeze on her clothing. She is ataxic but otherwise VSS. Her OG is 12, AG is 16, and her serum pH is 7.16. What is the most reasonable course of action?

  1. Administer fomepizole IV
  2. Initiate hemodialysis
  3. Administer calcium gluconate IV
  4. Administer thiamine IV
A
  1. Initiate hemodialysis
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12
Q

A 17 year old male has recently ingested an unknown quantity of amitriptyline. Which of the following ECG findings is most likely?

  1. Tachycardia and QRS widening
  2. Bradycardia and QRS widening
  3. Tachycardia and QT prolongation
  4. 1 and 3 are correct
A
  1. 1 and 3 are correct
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13
Q

A 16 year old female has ingested “a handful” of her grandfather’s medication. Vitals: Pulse 48 BP 70/40 Resp 16 Temp 37 Glucose 17. What did she most likely ingest?

  1. Metoprolol
  2. Digoxin
  3. Losartan
  4. Verapamil
A
  1. Verapamil
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14
Q

What is the most common cause of paediatric deaths in children aged 1 - 4 years?

  1. Congenital heart disease
  2. Trauma
  3. Submersion injury
  4. Sepsis
A
  1. Trauma
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15
Q

What is the most effective strategy to prevent submersion injuries in children?

  1. Personal flotation device in children > 12 months
  2. 4 sided fence with self-locking, self-closing gates
  3. Swimming instruction to bronze level
  4. Parent/caregiver CPR instruction
A
  1. 4 sided fence with self-locking, self-closing gates
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16
Q

A 14 y.o. M is pulled from an icy lake after being found face down. What is the most important strategy influencing survival?

  1. Immediate c-spine immobilization
  2. Immediate CPR by rescuers
  3. Passive external rewarming, EMS activation, and transport to health care facility for core rewarming
  4. Early placement of a definitive airway
A
  1. Immediate CPR by rescuers
17
Q

A 12 year girl was pulled from a lake and presents to the ED with a core temp of 28 C. What is the name given to the upward deflections on her ECG?

  1. Delta waves
  2. Epsilon waves
  3. Right bundle branch block
  4. Osborn waves
A
  1. Osborn waves
18
Q

A 5 y.o. male is pulled from a lake and presents to the ED apneic and pulseless. His core temp is 29 C. The most reasonable course of action is?

  1. BVM, CPR and IV epinephrine 1:10 000
  2. BVM, CPR and IV bretylium
  3. RSI, CPR and active external rewarming
  4. RSI, CPR and defibrillation to a maximum of 3 shocks
A
  1. RSI, CPR and active external rewarming
19
Q

An 8 y.o. male with CF presents to the ED during a heatwave with a core temp of 38 C. He is tachycardic and fatigued. What type of hyperthermic injury is he most at risk for?

  1. Heat cramp
  2. Heat exhaustion
  3. Heat stroke
  4. None of the above
A
  1. Heat exhaustion
20
Q

A 17 y.o. victim of an industrial fire sustained deep partial thickness burns to 25% BSA. He is ventilated and receives daily dressing changes. The leading cause of morbidity and mortality in this patient is?

  1. Asphyxiation
  2. Infection
  3. Renal failure secondary to volume losses
  4. Carbon monoxide intoxication
A
  1. Infection
21
Q

A 10 y.o. male was found unconscious near high tension wires. He is ventilated but stable. His ongoing management demands attention to which of the following sequelae?

  1. Respiratory failure
  2. Delayed spinal cord injury
  3. Acute renal failure
  4. Asystolic arrest
A
  1. Acute renal failure
22
Q

A 6 y.o. male presents with a metabolic acidosis after emerging from a house fire. there is no upper airway evidence of smoke inhalation. What is your next step in management?

  1. Cyanocobalamin kit
  2. Chest x-ray
  3. 100% oxygen
  4. Admit for observation
A
  1. Cyanocobalamin kit

Hamilton 2020 Questions (29 decks)

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