BOARD REVIEW QUESTIONS
March 2017 | Volume 17 Issue 3
Challenging ABEM style questions for enhanced learning and deeper understanding of the EMRAP program
www.emrap.org
Editor-in-Chief: Mel Herbert, MD Executive Editor: Stuart Swadron, MD Associate Editor: Dan Joseph, MD
Question #1 According to this month’s EMRAP segment with Rob Orman and Anand Swaminathan, which of the following should be the first thing addressed when giving report on a patient you are trying to admit to a hospitalist? 1. Chief complaint 2. Diagnosis 3. History of present illness 4. Insurance status Question #2 A 55-year old obese female is intubated for pneumonia and respiratory failure. She is 5 feet tall and weighs 200 kg. Which of the following is the most appropriate tidal volume for this patient? 1. 2. 3. 4.
350 cc 500 cc 750 cc 1000 cc
Question #3 When titrating down the FiO2 after intubation, which of the following is your goal oxygen saturation? 1. 85% 2. 90% 3. 95% 4. 100% Question #4 Which of the following is NOT a risk factor for acute coronary syndrome? 1. Age 2. Diabetes 3. HIV status 4. Smoking history 5. All of the above are risk factors Question #5 Which of the following is true regarding the use of normal saline in comparison to tap water for wound irrigation prior to suturing? 1. 2. 3. 4.
Normal saline can cause direct tissue injury Normal saline results in a lower infection rate Normal saline results in improved wound healing No significant difference was seen
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BOARD REVIEW QUESTIONS
Question #6 According to this month’s segment with Ilene Claudius, which of the following is the most accurate measure of estimating a child’s weight? 1. 2. 3. 4.
Age based using a formula Length based Parent’s estimate Waist size based
Question #7 A 25 week preterm neonate is born suddenly in your resuscitation bay. Which of the following is the correct uncuffed endotracheal tube size? 1. 2.0 2. 2.5 3. 3.0 4. 3.5 Question #8 A 6-week old male is brought in by his parents for difficulty feeding. They report that each time he feeds he becomes sweaty, grunts, and appears to be in pain. Physical exam reveals a systolic murmur and chest radiograph shows an enlarged heart. EKG shows anterior q waves as well as poor R wave progression. Which of the following is the most likely diagnosis? 1. ALCAPA 2. Tetralogy of Fallot 3. Truncus arteriosus 4. Patent ductus arteriosus Question #9 A 45-year old male presents to the Emergency Department after he was struck by a car. Physical exam reveals gross instability of the pelvis and radiographs reveal an open book pelvic fracture. A pelvic binder is applied. According to this month’s segment with Kenji Inaba, when should this binder be removed? 1. After x-ray 2. After transfusion 3. Immediately 4. Upon arrival to the ICU Question #10 A 55-year old male presents to the Emergency Department with chest pain. EKG at triage reveals anterior ST elevations with inferior ST depressions. A code STEMI is activated. The patient appears very uncomfortable and a nurse asks about giving morphine. According to this month’s EMRAP segment with Bryan Hayes, which of the following is an important potential side effect of morphine for this patient? 1. 2. 3. 4.
Decreased absorption of clopidogrel or ticagrelor Decreased aspirin absorption Increased absorption of clopidogrel or ticargrelor Platelet inhibition
Question #11 Which of the following most accurately reflects the role of a tactical EMS provider? 1. 2. 3. 4.
Care for wounded civilians Care for wounded SWAT team members Triage of wounded civilians Oversight of disaster planning
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BOARD REVIEW QUESTIONS
Question #12 Which of the following treatments should be performed in a hot zone during an active shooter incident? 1. Airway management 2. CPR 3. Tourniquet placement 4. None of the above Question #13 According to this month’s EMRAP segment, which of the following is the most common cause of agitation in the intubated patient? 1. 2. 3. 4.
Inadequate analgesia Inadequate sedation High tidal volumes High PEEP
Question #14 A 34-year old male presents to the Emergency Department after a fall from a balcony onto his feet. He endorses right foot pain only. The remainder of his physical exam is unremarkable. X-ray is shown. What is the appropriate disposition for this patient?
Image from http://www.southfloridasportsmedicine.com/images/calcaneal_fracture.jpg 1. 2. 3. 4.
Discharge with bulky jones dressing and non-weight bearing Discharge with posterior long leg splint and non-weight bearing Discharge with posterior long leg splint and weight bearing as tolerated Emergent surgical repair
Question #15 According to this month’s segment with Reuben Strayer, which of the following opioids is associated with the LEAST euphoria and thus lower risk for addiction? 1. 2. 3. 4.
Hydrocodone-acetaminophen combination Hydrocodone alone Oral morphine Oxycodone
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Question #16 According to the recent Resuscitation article discussed in this month’s Paper Chase, which of the following was observed with therapeutic hypothermia in pediatric patients? 1. 2. 3. 4.
Increased mortality Improved survival to discharge Improved neurologic function No significant change was seen
Question #17 According to this month’s Paper Chase on the recent Academic Emergency Medicine study on coronary CT, which of the following was seen in the group of patients undergoing coronary CT? 1. 2. 3. 4.
Decreased rate of myocardial infarction at 30 days Improved mortality No change in rate of myocardial infarction at 30 days but an increase in invasive procedures performed No change in rate of myocardial infarction at 30 days but a reduction in invasive procedures performed
Question #18 Which of the following was seen after implementing a text message system to utilize volunteers trained in ALS and BLS as first responders to cardiac arrest? 1. 2. 3. 4.
Decreased AED usage Improved survival Increased scene time No significant change
Question #19 A 55-year old male presents to the Emergency Department after a motorcycle accident. Vital signs are: HR 115, RR 20, BP 95/70, O2 96%. Bedside FAST exam is positive. According to the recent Journal of Trauma article discussed in this month’s Paper Chase, which of the following is associated with blood transfusion administered in the first hour? 1. 2. 3. 4.
Increased coagulopathy Increased survival Increased transfusion requirement Prolonged ICU stay
Question #20 A 65-year old male presents to the Emergency Department with a diffuse rash. He reports several weeks of fevers and chills as well as a progressive intensely pruritic rash. Vital signs are: HR 110, RR 20, BP 140/90, T 98.6ºF (37ºC). Physical exam reveals a desquamative erythroderma involving over 80% of his skin surface as well as palpable lymphadenopathy. Which of the following is the most likely cause of this patient’s presentation? 1. 2. 3. 4.
DRESS syndrome Sezary syndrome Stevens Johnson syndrome Toxic shock syndrome
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