ABEM Cardiovascular & Respiratory Emergencies 3

Question 1

A 55-year-old man with hypertension presents with acute pulmonary edema. His BP is 220/130 mmHg. Which vasodilator acts primarily as a venodilator to rapidly reduce preload?

Accepted Answer

Nitroglycerin

Answer

Nitroglycerin at low doses acts primarily as a venodilator, rapidly reducing preload and relieving acute pulmonary congestion.

Question 2

Which of the following is the MOST common cause of massive hemoptysis requiring emergency intervention?

Accepted Answer

Bronchiectasis

Answer

Bronchiectasis is the most common cause of massive hemoptysis due to hypertrophied bronchial arteries and recurrent infections.

Question 3

A patient presents in wide-complex tachycardia at 180 bpm, is hemodynamically stable. The rhythm is regular and the QRS morphology is LBBB pattern. The SAFEST initial pharmacologic treatment is:

Accepted Answer

Procainamide

Answer

Procainamide is the preferred agent for stable wide-complex tachycardia of uncertain origin; verapamil and other AV nodal blockers can cause deterioration in VT.

Question 4

In a patient with suspected tension pneumothorax, what is the IMMEDIATE management?

Accepted Answer

Needle decompression at 2nd ICS midclavicular line

Answer

Tension pneumothorax is a clinical diagnosis requiring immediate needle decompression without waiting for imaging to prevent cardiac arrest.

Question 5

A 62-year-old female presents with acute dyspnea, pleuritic chest pain, and leg swelling after a 10-hour flight. D-dimer is elevated. The MOST appropriate next step is:

Accepted Answer

CT pulmonary angiography

Answer

CT pulmonary angiography (CTPA) is the gold standard imaging study for diagnosing pulmonary embolism in patients with intermediate-to-high clinical probability.

(ABEM) American Board of Emergency Medicine Practice Test

(ABEM) American Board of Emergency Medicine Practice Test

ABEM Cardiovascular & Respiratory Emergencies 3