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A series of questions and answers related to acute medical conditions, designed to test and reinforce knowledge in emergency medical care. It covers a range of topics including neurological emergencies, respiratory distress, shock, endocrine disorders, and toxicology. Each question is followed by a verified solution, making it a valuable resource for healthcare providers and students preparing for exams or seeking to enhance their understanding of critical care scenarios. The content is structured to facilitate quick review and comprehension, ensuring that users can efficiently grasp key concepts and best practices in emergency medicine. This resource is particularly useful for those in advanced medical training or certification programs, offering a concise yet comprehensive overview of essential topics in acute care. The questions are designed to simulate real-world scenarios, promoting critical thinking and effective decision-making in high-pressure situations.
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A 28 year old female is being evaluated for an acute onset of an alteration in mentation. She complained of a stiff neck and persistent headache. Vital signs are P112, R22 and regular, BP 144/88, SpO2 95% and T 102.3F (39C). The healthcare provider should observe for which complication?
Seizure
A 45 year old patient is found supine on the floor of the Triage area. Healthcare providers note pinpoint pupils, shallow respirations and vomitus in and around the mouth. What course of action should be implemented next?
Supplemental oxygen and suction
Patients with a history of chronic bronchitis that present with shortness of breath are likely to have which condition?
Pulmonary embolism
Acute Respiratory Distress Syndrome (ARDS) is characterized by what pathological change?
Breakdown of fluid between the alveolar-capillary membrane
An anxious male complains of a sore throat, fever, chills, dental pain and dyspnea. the patient has a firm, red pronounced swelling in the sublingual anterior throat area and tongue. What diagnosis is most likely?
Ludwig's angina
Healthcare providers are assessing a patient with pronounced jugular vein distention and muffled heart tones. Vitals are P 128, R 26, BP 74/52. What classification of shock should be suspected?
Obstructive
During compensatory shock, the renin-angiotensin-aldosterone system is activated to cause a/an:
Increase in preload, afterload and re-absorption of sodium
A 42 year old patient with a history of rheumatoid arthritis is taking glucocorticoids. Over the past two weeks, she complains of chronic fatigue, weakness, and loss of appetite with weight loss. Lab results indicate hyponatremia and hyperkalemia. What underlying diagnosis is suspected?
Adrenal insufficiency
Which condition should the healthcare provider consider to usually be a non- emergent, non-life threatening illness?
Thoracic outlet syndrome
Healthcare providers should use extreme caution with nitroglycerin when ST elevation is present in which ECG leads?
II, III, aVF
Which is a high-risk factor for intracerebral hemorrhage?
Cocaine drug abuse
An autoimmune disease which produces antibodies that mimic the role of TSH and cause an increase in thyroid hormones is:
Grave's disease
Glucagon may not be effective treatment for a patient with hypoglycemia if they also have which underlying illness?
Alcoholism
A 24 year old has completed a triathlon on a hot, humid day. The athlete complains of a severe headache, muscle cramps and abdominal pain. As the patient history is obtained, the athlete becomes lethargic. What underlying electrolyte disturbance should the healthcare provider most likely suspect?
Hyponatremia
What is the sign on the ECG that will indicate a patient is experiencing hyperkalemia?
Peaked T waves
An 82 year old alcoholic complains of nausea, non-bloody vomiting and severe epigastric and right upper quadrant pain that radiates to the back. Palpation reveals epigastric tenderness without peritoneal signs. What working diagnosis should be considered most likely?
Acute pancreatitis
A 23 year old male complains of a productive cough, fever, chills and pleuritic chest pain that has worsened over 3 days. A physical exam reveals unilateral wheezing with shallow respirations. Vitals are P 128, R 26, BP 144/88, SpO2 90%, and T 102°F (38.8°C). What treatment should be performed?
Supplemental Oxygen and immediate transport
The patient presents with a history of headache, weight loss, chest discomfort, night sweats and a persistent cough for several weeks. Which infectious disease is most likely occurring?
Tuberculosis
A lethargic patient presents with dilated pupils and vital signs of P 122, R 26 and BP 130/80. He admits to excessive ingestion of diphenhydramine. What response is the cause for the presenting signs and symptoms?
Anticholinergic
Organophosphate poisoning will present with which signs and symptoms?
Salivation and incontinence of urine and liquid stool
What medication classification should be administered to an uncooperative, agitated patient?
Benzodiazepine
A patient presents with mildly decreased mental status, slow respirations, bradycardia, hypotension, has a blood sugar of 42mg/dl (2.3 mmolL). This is most likely caused from excessive ingestion of:
Beta blockers
The patient complains of a deep burning discomfort diffusely throughout the epigastrium. This is an example of which type of pain?
Visceral
A patient describes an "aching" sensation in his chest. It occurred suddenly while resting and radiates to the jaw. He self administered 1 nitroglycerin tablet without relief and the 12 lead reveals a normal sinus rhythm with ST elevation in leads II, III, and aVF. What working diagnosis is most likely?
Inferior wall myocardial injury
Healthcare providers are managing a patient presenting with substernal chest discomfort. They describe the pain as "pressure-like" and it radiates to the jaw and left arm. The discomfort subsides with rest, oxygen and administration of nitroglycerin. What is the most likely working diagnosis?
Angina pectoris
Which infectious disease must have oxygen present to survive? Tuberculosis
Which best practices help to prevent the spread of infectious disease?
Handwashing before and after all patient contact and standard precautions
Continuous positive airway pressure would be most appropriate in treating which patient?
22 year old with severe asthma and not responding to nebulizer treatments
A patient has attempted suicide by ingesting ethylene glycol about 20 hours prior to arriving for treatment. Lung sounds reveal bilateral crackles and respirations of 30 with symptoms of pulmonary edema and cyanosis of the lips. The ECG reveals ventricular tachycardia. Which stage of ethylene glycol poisoning has occurred?
The determination of a working diagnosis is dependent on the provider's assessment, critical thinking and ____________________ __________________________ skills.
Pattern recognition
When performing a patient assessment, what information provides the most essential information in determining a working diagnosis?
Medical history
Clinical reasoning requires the healthcare provider to:
Process relevant information, filter out irrelevant information
According to the AMLS Assessment Pathway, determining whether a patient is "Sick or Not Sick" is initially done which component of the assessment process?
First impression
Select an example of a communication barrier that impairs an efficient and thorough assessment process.
The patient can't find his hearing aid
Healthcare providers are treating an unresponsive patient who overdosed on lorazepam. What intervention should be initiated?
Airway support