AEMCA MCQ 3 — Questions and Answers
Question 1: A patient with a history of diabetes is found confused, diaphoretic, and trembling. Blood glucose reads 42 mg/dL. The patient cannot swallow safely. What is the best treatment?
- Administer oral glucose gel under the tongue
- Administer 25 g of 50% dextrose (D50) IV (Correct answer)
- Give glucagon 1 mg IM and transport
- Apply a glucose patch and monitor
Correct answer: Administer 25 g of 50% dextrose (D50) IV
For a hypoglycemic patient who cannot protect their airway or swallow, IV dextrose (D50W) 25 g is the most reliable and fastest treatment.
Question 2: When assessing a burn patient, which formula is used to estimate the total body surface area (TBSA) burned in adults?
- Lund and Browder chart only
- Rule of Nines (Correct answer)
- Parkland formula
- Glasgow Burn Score
Correct answer: Rule of Nines
The Rule of Nines divides the adult body into regions each representing 9% (or multiples) of TBSA for rapid burn area estimation.
Question 3: A patient has ingested an unknown organophosphate pesticide. Which cluster of symptoms is most consistent with organophosphate toxidrome?
- Dry skin, dilated pupils, tachycardia, and urinary retention
- Diaphoresis, miosis, bronchospasm, salivation, and bradycardia (Correct answer)
- Fever, rigidity, altered mental status, and hypertension
- Euphoria, miosis, respiratory depression, and bradycardia
Correct answer: Diaphoresis, miosis, bronchospasm, salivation, and bradycardia
Organophosphates cause cholinergic toxidrome (SLUDGE/DUMBELS): salivation, lacrimation, urination, defecation, GI distress, emesis, miosis, bradycardia, and bronchospasm.
Question 4: During a difficult airway scenario, you have failed two intubation attempts. The patient's SpO2 is dropping to 85%. What is the next best intervention?
- Attempt a third laryngoscopy with a different blade
- Perform a surgical cricothyrotomy
- Insert a supraglottic airway device (e.g., King LT or LMA) (Correct answer)
- Continue BVM ventilation indefinitely
Correct answer: Insert a supraglottic airway device (e.g., King LT or LMA)
Following a failed intubation, the next step per failed airway algorithms is placement of a supraglottic airway device to restore oxygenation before considering surgical airway.
Question 5: Which finding on a 12-lead ECG is most consistent with a STEMI involving the right coronary artery (inferior MI)?
- ST elevation in leads V1–V4
- ST elevation in leads II, III, and aVF (Correct answer)
- ST elevation in leads I and aVL
- ST elevation in leads V5–V6 and I
Correct answer: ST elevation in leads II, III, and aVF
Inferior STEMI caused by right coronary artery occlusion produces ST elevation in the inferior leads: II, III, and aVF.
Question 6: A 25-year-old male was stabbed in the left chest. He is in severe respiratory distress with absent breath sounds on the left. After sealing the wound, his condition worsens. What should you do?
- Apply a second occlusive dressing over the first
- Briefly lift or 'burp' the dressing to release trapped air (Correct answer)
- Perform needle decompression on the right side
- Initiate CPR immediately
Correct answer: Briefly lift or 'burp' the dressing to release trapped air
If an occlusive chest seal causes worsening, it may be trapping air; briefly lifting (burping) the dressing allows pressure to escape and can relieve tension pneumothorax.
Question 7: In a patient experiencing status epilepticus lasting more than 5 minutes, which medication is the preferred initial treatment?
- Phenytoin 20 mg/kg IV
- Lorazepam 4 mg IV (or diazepam/midazolam) (Correct answer)
- Valproate 40 mg/kg IV
- Levetiracetam 60 mg/kg IV
Correct answer: Lorazepam 4 mg IV (or diazepam/midazolam)
Benzodiazepines such as lorazepam (4 mg IV), diazepam, or midazolam are the first-line agents for terminating status epilepticus.
AEMCA MCQ 3
A patient with a history of diabetes is found confused, diaphoretic, and trembling.
Blood glucose reads 42 mg/dL.
The patient cannot swallow safely.
What is the best treatment?