Ep 2 Roshcast Emergency Board Review

Welcome back to Roshcast Emergency Medicine Board Review Episode 2. 

Similar to how ED physicians have no control over the next patient who rolls through the door, we are going to, once again, answer questions as they are randomly generated by the question bank.

In case you missed episode one. 

Remember, we need your feedback. Please send it to [email protected] 

Lets get started…

Question 1

Nitrate therapy works by which of the following mechanisms?

A. Reducing afterload

B. Reducing both preload and afterload

C. Reducing cardiac contractility

D. Reducing preload

Teaching card to supplement answer

Question 2

What is the most common exam finding reported in patients with acute aortic dissection?

A.  Aortic insufficiency

B.  Hypertension

C.  Hypotension

D.  Pulse deficit

Teaching card to supplement answer

Question 3

A 32-year-old woman, who is at 20 weeks gestational age, presents to the ED after a seizure. Her vital signs are BP 115/70, HR 105, RR 16, T 37.5°C, and pulse oximetry 98% on room air. On exam, you note some confusion, but otherwise there are no focal deficits. Lab results reveal a hemoglobin of 7 g/dL and platelets of 12,000/µL. A peripheral blood smear reveals schistocytes. Which of the following is the most appropriate treatment for her condition?

A.  Delivery of fetus

B.  Magnesium sulfate

C.  Plasmapheresis

D.  Platelet transfusion

Teaching card to supplement answer

Question 4

A 72-year-old man presents for evaluation of palpitations. He has a regular, wide complex tachycardia at a rate of 140. Which of the following supports a diagnosis of ventricular tachycardia?

A.  Discordance of the QRS axis in the precordial leads

B.  Fusion beats

C.  Leftward axis

D.  ST elevation greater than 5 mm

Teaching card to supplement answer

Question 5

A 3-year-old girl presents to the ED with her mom and grandmother for evaluation of vaginal spotting. The child has no other complaints and specifically denies sexual abuse or trauma when questioned alone. After watching a news special on sexual abuse, mom is concerned that her daughter may have been sexually assaulted, despite no specific concern. The child is acting appropriately and there are no external lesions or signs of trauma. Internal pelvic exam is difficult due to the patient’s age. Which of the following statements is true?

A.  Obtain a pelvic x-ray prior to attempting a physical exam

B.  She is the victim of abuse; do no further evaluation without a trained nurse present and contacting authorities

C.  She may have a vaginal foreign body; consider a nasal speculum to attempt visualization and removal

D.  Vaginitis is an unusual diagnosis in this age group

Question 6 

A 27-year-old woman currently breast-feeding presents to the ED with an inflamed and painful right breast. Her vital signs are BP 125/70 mm Hg, HR 105, RR 16, and T 38.3°C. On exam, you note extensive cellulitis of the right breast that begins at the nipple.