Mixed Deck — All ABEM Topics Flashcards

After a house fire, a victim presents with confusion, cherry-red skin, and carboxyhemoglobin of 28%. What is the half-life of COHb with 100% normobaric oxygen?

Answer: ~60–90 minutes

100% normobaric oxygen reduces the carboxyhemoglobin half-life from ~5 hours on room air to approximately 60–90 minutes.

A patient with known COPD presents with acute exacerbation. SpO2 is 82%. What is the target oxygen saturation range for this patient?

Answer: 88-92%

In COPD patients with chronic hypercapnia, target SpO2 is 88-92% to avoid suppressing the hypoxic drive and worsening hypercapnia.

A restrained driver sustains a lap-belt abdominal bruise pattern. Which injury triad is classically associated with this mechanism?

Answer: Chance fracture, hollow viscus injury, mesenteric tear

The lap-belt complex includes Chance fracture (flexion-distraction lumbar), bowel/mesenteric injury from compression against the spine.

A 45-year-old woman presents with sudden syncope. ECG shows a prolonged QTc of 520ms and polymorphic VT. The first-line treatment is:

Answer: Magnesium sulfate IV

Torsades de pointes (polymorphic VT with prolonged QT) is treated first with IV magnesium sulfate 1-2g regardless of serum magnesium level.

A 70-year-old presents with sudden loss of pain and temperature sensation over his right arm and leg, with left-sided face numbness, and left-sided Horner syndrome. Which vessel is most likely occluded?

Answer: Left posterior inferior cerebellar artery

Left PICA occlusion causes lateral medullary (Wallenberg) syndrome with left-sided Horner and facial sensory loss, and crossed (right-sided) body pain/temperature loss via spinothalamic tract.

Which foundational principle is MOST important for success in the American Board of Emergency Medicine profession?

Answer: Commitment to continuous learning, ethical practice, and quality outcomes

Success in any professional field requires a commitment to continuous learning to stay current, ethical practice to maintain trust and integrity, and a focus on quality outcomes that serve stakeholders and the public interest.

A 28-year-old asthmatic presents with severe wheezing, cannot speak in full sentences, HR 128, and SpO2 88%. After initial bronchodilators, what adjunct treatment is MOST appropriate?

Answer: Systemic corticosteroids

Systemic corticosteroids (IV methylprednisolone or oral prednisone) reduce airway inflammation and decrease length of stay in severe asthma exacerbations.

What is a FAST exam used for?

Answer: Internal bleeding

A FAST (Focused Assessment with Sonography for Trauma) exam is a rapid ultrasound scan performed in emergency settings. Its primary purpose is to quickly identify free fluid, typically blood, in specific body cavities like the pericardium, perihepatic, perisplenic, and pelvic regions. This helps detect significant internal bleeding in trauma patients, guiding immediate management decisions.

Which statement BEST describes the relationship between American Board of Emergency Medicine certification requirements and industry evolution?

Answer: Requirements evolve periodically to reflect advances in knowledge, technology, and practice standards

Certification requirements evolve to keep pace with advances in professional knowledge, technological developments, and changes in practice standards. This ensures that certified professionals remain current and competent in a changing professional landscape.

A patient with end-stage renal disease on dialysis presents with shortness of breath, JVD, crackles, and BP 200/110. What is the most appropriate ED treatment?

Answer: Nitroglycerin and emergent dialysis

ESRD patients are anuric and unresponsive to diuretics; nitroglycerin for afterload reduction and emergent dialysis is definitive treatment for flash pulmonary edema.

A patient is found unconscious with empty bottles of amitriptyline and alcohol. ECG shows a QRS of 140 ms and right axis deviation of the terminal 40 ms. What is the most appropriate initial treatment?

Answer: Sodium bicarbonate 1–2 mEq/kg IV bolus

Sodium bicarbonate narrows the QRS in tricyclic antidepressant overdose by increasing serum sodium and alkalinizing the blood, reversing sodium channel blockade.

What is the PRIMARY ethical obligation of a certified American Board of Emergency Medicine professional regarding confidential information?

Answer: Protect it from unauthorized disclosure at all times

Confidentiality is a fundamental ethical obligation. Certified professionals must protect confidential information from unauthorized disclosure, regardless of circumstances. Breach of confidentiality can result in loss of certification and legal liability.

Which ECG finding during SVT suggests the rhythm is atrial flutter rather than AVNRT?

Answer: Sawtooth flutter waves at 300 bpm in leads II, III, aVF

Atrial flutter characteristically shows sawtooth flutter waves at approximately 300 bpm (atrial rate) in inferior leads, often with 2:1 AV conduction giving a ventricular rate of 150 bpm.

Which of the following ECG findings is MOST specific for right heart strain in pulmonary embolism?

Answer: S1Q3T3 pattern

The S1Q3T3 pattern (S wave in lead I, Q wave and T-wave inversion in lead III) is the classic but not sensitive ECG finding in PE suggesting right heart strain.

In American Board of Emergency Medicine, what is the PRIMARY purpose of conducting regular safety drills and exercises?

Answer: To ensure personnel can respond effectively in emergencies

Regular safety drills ensure that all personnel are prepared to respond effectively during actual emergencies. Practice builds muscle memory, identifies gaps in emergency procedures, and improves overall response times.

What is a symptom of carbon monoxide poisoning?

Answer: Headache and confusion

Carbon monoxide (CO) is a colorless, odorless gas that binds to hemoglobin more readily than oxygen, leading to cellular hypoxia. Common symptoms of CO poisoning, often mistaken for flu, include headache, dizziness, nausea, and confusion. Severe poisoning can lead to loss of consciousness, seizures, and death due to oxygen deprivation to vital organs.

How does the ABEM body of knowledge relate to daily professional practice?

Answer: It provides the foundational framework that guides decision-making and standard practices

The body of knowledge provides the foundational framework of principles, standards, and best practices that professionals use to guide their daily decision-making, ensure consistent quality, and maintain alignment with industry standards.

In cardiac tamponade, Beck's triad includes hypotension, muffled heart sounds, and:

Answer: Jugular venous distension

Beck's triad consists of hypotension, muffled heart sounds, and jugular venous distension (JVD) due to impaired cardiac filling.

What is the MOST effective way for new ABEM professionals to build competency in their field?

Answer: Combining formal education, mentored practice, and ongoing professional development

Building professional competency requires a multi-faceted approach: formal education provides foundational knowledge, mentored practice develops applied skills under guidance, and ongoing professional development ensures continuous growth and currency in the field.

A ABEM certified professional is asked to provide services outside their scope of competence. The CORRECT ethical response is to:

Answer: Decline and refer to a qualified professional

Ethical practice requires professionals to work within their scope of competence. Accepting work beyond one's qualifications can lead to substandard results and potential harm. Referring to qualified professionals ensures proper service delivery.