ABFAS Emergency Response Procedures 3

Question 1

A patient in the PACU after ankle surgery develops sudden onset respiratory distress, tachycardia, and hypoxia with oxygen saturation of 84%. Breath sounds are absent on the right. The MOST likely diagnosis is:

Accepted Answer

Pneumothorax from interscalene nerve block

Answer

Unilateral absent breath sounds following an interscalene or supraclavicular nerve block strongly suggest ipsilateral pneumothorax, a known complication.

Question 2

A patient with a known penicillin allergy receives cefazolin for surgical prophylaxis and develops urticaria. The cross-reactivity rate between penicillins and cephalosporins is approximately:

Accepted Answer

Less than 2%

Answer

The true cross-reactivity rate between penicillins and cephalosporins is less than 2%, much lower than historically reported 10% figures.

Question 3

Which finding on arterial blood gas (ABG) is most consistent with acute respiratory failure requiring immediate intubation?

Accepted Answer

pH 7.20, PaO2 52 mmHg, PaCO2 58 mmHg on maximal O2

Answer

Severe acidosis (pH 7.20), significant hypoxemia (PaO2 52), and hypercapnia (PaCO2 58) despite maximal supplemental oxygen indicate impending respiratory failure requiring intubation.

Question 4

In a patient with suspected deep vein thrombosis (DVT) following foot and ankle surgery, which initial diagnostic test is most appropriate?

Accepted Answer

Lower extremity venous duplex ultrasound

Answer

Compression duplex ultrasound of the lower extremity is the first-line imaging modality for diagnosing DVT due to its safety, availability, and accuracy.

Question 5

A postoperative patient develops fever of 39.5°C, hypotension, tachycardia, and altered mental status 48 hours after an open reduction internal fixation. Blood cultures are drawn. What is the MOST appropriate immediate intervention?

Accepted Answer

Begin broad-spectrum IV antibiotics within 1 hour

Answer

Sepsis requires broad-spectrum IV antibiotics within 1 hour of recognition per Surviving Sepsis Campaign guidelines to reduce mortality.

(ABFAS) American Board of Foot and Ankle Surgery Practice Test

(ABFAS) American Board of Foot and Ankle Surgery Practice Test

ABFAS Emergency Response Procedures 3