Emergency and Urgent Care Flashcards

A 62-year-old presents with sudden severe eye pain, blurred vision, halos around lights, nausea, and a mid-dilated nonreactive pupil. What is the most appropriate immediate action?

Answer: Start IOP-lowering therapy and obtain emergent ophthalmology referral

Acute angle-closure glaucoma is a sight-threatening emergency requiring IOP-lowering agents (e.g., topical beta-blocker, acetazolamide) and emergent ophthalmology care.

A patient develops hives, wheezing, and hypotension minutes after a bee sting. Which is the first-line treatment?

Answer: Intramuscular epinephrine 0.3–0.5 mg in the anterolateral thigh

IM epinephrine in the anterolateral thigh is the first-line, time-critical treatment for anaphylaxis, with antihistamines and steroids only adjunctive.

According to the Ottawa ankle rules, which finding indicates the need for an ankle radiograph?

Answer: Inability to bear weight for four steps both immediately and in the clinic

Inability to bear weight for four steps, or bony tenderness at the malleolar zone, indicates the need for imaging under the Ottawa rules.

A trauma patient has absent breath sounds on the right, distended neck veins, tracheal deviation, and hypotension. What is the immediate intervention?

Answer: Needle decompression of the affected hemithorax

Tension pneumothorax is a clinical diagnosis requiring immediate needle or finger decompression without waiting for imaging.

A 70-kg adult has 20% TBSA second- and third-degree burns. Using the Parkland formula, how much fluid should be given in the first 8 hours?

Answer: 2,800 mL

Parkland is 4 mL × 70 kg × 20 = 5,600 mL over 24 hours, with half (2,800 mL) given in the first 8 hours from time of burn.

A patient is found unresponsive with pinpoint pupils and a respiratory rate of 6/min. After airway support, which medication is indicated?

Answer: Naloxone

Naloxone reverses opioid-induced respiratory depression, given alongside ventilatory support.

A 14-year-old boy has sudden severe left scrotal pain, nausea, an absent cremasteric reflex, and a high-riding testis. What is the best next step?

Answer: Emergent urology consultation for surgical exploration

Testicular torsion is a surgical emergency with best salvage within about 6 hours, so imaging must not delay urology involvement.