Emergency Medicine_Selected Topics_RR

Question 1

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

Answer 1

Antipsychotic (neuroleptic malignant syndrome)

Question 2

Side effects of corticosteroids

Answer 2

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

Question 3

Treatment for delirium tremens

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

Question 7

Treatment for neuroleptic malignant syndrome and malignant hyperthermia

Answer 7

Dantrolene

Question 8

Treatment for malignant hypertension

Answer 8

Nitroprusside

Question 9

Treatment for atrial fibrillation

Answer 9

Rate control, rhythm conversion, and anticoagulation

Question 10

Treatment of supraventricular tachycardia

Answer 10

If stable: rate control with carotid massage or other vagal stimulation;
If unsuccessful, consider amiodarone

Question 11

Causes of drug-induced SLE.

Answer 11

Isoniazid, pencillamine, hydralazine, procainamide, chlorpromazine, methyldopa, quinidine

Question 12

Macrocytic, megaloblastic anemia with neurologic symptoms

Answer 12

B12 deficiency

Question 13

Macrocytic, megaloblastic anemia without neurologic symptoms

Answer 13

Folate deficiency

Question 14

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

Answer 14

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

Question 15

Blood in the urethral meatus or high-riding prostate.

Answer 15

Bladder rupture or urethral injury

Question 16

Test to rule out urethral injury

Answer 16

Retrograde cystourethrogram

Question 17

Radiographic evidence of aortic disruption or dissection

Answer 17

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

Question 18

Radiographic indications for surgery in patients with acute abdomen

Answer 18

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

Question 19

The most common organism in burn-related infections

Answer 19

Pseudomonas

Question 20

Method of calculating fluid repletion in burn patients

Answer 20

Parkland formula:

24-hour fluids = 4 x kg x % body surface area

Question 21

Acceptable urine output in a trauma patient

Answer 21

50 cc/hr

Question 22

Acceptable urine output in a stable patient

Answer 22

30 cc/hr

Question 23

Signs of neurogenic shock

Answer 23

Hypotension and bradycardia

Question 24

Signs of increased intracranial pressure (Cushing’s triad)

Answer 24

Hypertension, bradycardia, and abnormal respirations

Question 25

Decreased CO and PCWP | Increased peripheral vascular resistance (PVR)

Answer 25

Hypovolemic shock

Question 26

Decreased CO | Increased PCWP and PVR

Answer 26

Cardiogenic (or obstructive) shock

Question 27

Increased CO | Decreased PCWP and PVR

Answer 27

Septic or anaphylactic shock

Question 28

Treatment of septic shock

Answer 28

Fluids and antibiotics

Question 29

Treatment of cardiogenic shock

Answer 29

Identify cause; pressors (eg, dopamine)

Question 30

Treatment of hypovolemic shock

Answer 30

Identify cause; fluid and blood repletion

Question 31

Treatment of anaphylactic shock

Answer 31

Diphenhydramine or epinephrine 1:1000

Question 32

Supportive treatment for ARDS.

Answer 32

Continuous positive airway pressure (CPAP)

Question 33

Signs of air embolism

Answer 33

A patient with chest trauma who was previously stable suddenly dies

Question 34

Signs of cardiac tamponade

Answer 34

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

Question 35

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

Answer 35

Massive hemothorax

Question 36

Absent breath sounds, tracheal deviation, distended neck veins

Answer 36

Tension pneumothorax

Question 37

Treatment for blunt or penetrating abdominal trauma in hemodynamically unstable patients

Answer 37

Immediate exploratory laparotomy

Question 38

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

Answer 38

Subdural hematoma

Question 39

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

Answer 39

Epidural hematoma