ABPS Emergency Medicine & Acute Care 3

Question 1

A patient presents with acute respiratory distress, PaO2/FiO2 ratio of 180 mmHg, bilateral infiltrates on CXR, and no evidence of cardiogenic pulmonary edema. This presentation is consistent with which condition?

Accepted Answer

Acute Respiratory Distress Syndrome (ARDS)

Answer

ARDS is defined by acute onset, bilateral infiltrates, PaO2/FiO2 ratio <300 mmHg, and absence of cardiogenic pulmonary edema — this case meets Berlin Definition criteria for moderate ARDS.

Question 2

Which of the following ECG findings is most characteristic of hyperkalemia at dangerous serum potassium levels (>6.5 mEq/L)?

Accepted Answer

Peaked T waves progressing to sine wave pattern

Answer

Severe hyperkalemia classically progresses from peaked T waves to widened QRS, loss of P waves, and ultimately a sine wave pattern indicating risk of fatal arrhythmia.

Question 3

A patient is brought in after a suspected opioid overdose. Physical exam shows miosis, bradypnea (8 breaths/min), and altered consciousness. What is the treatment of choice?

Accepted Answer

Naloxone IV or intranasal

Answer

Naloxone is the specific opioid antagonist that rapidly reverses opioid-induced CNS and respiratory depression, and is the treatment of choice for opioid overdose.

Question 4

Which scoring system is commonly used in the emergency department to risk-stratify patients presenting with upper GI bleeding?

Accepted Answer

Glasgow-Blatchford Score

Answer

The Glasgow-Blatchford Score uses clinical and laboratory parameters to predict the need for intervention in upper GI bleeding and helps determine safe outpatient versus inpatient management.

Question 5

A patient presents with a suspected pulmonary embolism. Wells score indicates high probability. What is the most appropriate next diagnostic step?

Accepted Answer

CT pulmonary angiography (CTPA)

Answer

In patients with high clinical probability for PE, CT pulmonary angiography is the diagnostic test of choice as it directly visualizes pulmonary emboli with high sensitivity and specificity.

(ABPS) American Board of Physician Specialties Certification Practice Test

(ABPS) American Board of Physician Specialties Certification Practice Test

ABPS Emergency Medicine & Acute Care 3