AEMCA Medical Emergencies 3 — Questions and Answers
Question 1: Which electrolyte abnormality is most associated with peaked T-waves and widened QRS complex on ECG?
- Hyponatremia
- Hyperkalemia (Correct answer)
- Hypercalcemia
- Hypomagnesemia
Correct answer: Hyperkalemia
Hyperkalemia causes progressive ECG changes including peaked T-waves, prolonged PR interval, widened QRS, and ultimately a sine-wave pattern.
Question 2: A patient with COPD is found unconscious with a respiratory rate of 6 breaths/min. Which oxygen delivery concern is most relevant?
- Risk of nitrogen narcosis
- Suppression of hypoxic respiratory drive (Correct answer)
- Oxygen toxicity to lung tissue
- Absorption atelectasis
Correct answer: Suppression of hypoxic respiratory drive
Some COPD patients rely on hypoxic drive to breathe; high-flow oxygen can suppress this drive and worsen hypoventilation.
Question 3: In a patient with suspected pulmonary embolism, which triad of findings is classically described?
- Hemoptysis, pleuritic chest pain, dyspnea (Correct answer)
- Fever, productive cough, decreased breath sounds
- Chest pain, syncope, bradycardia
- JVD, tracheal deviation, absent breath sounds
Correct answer: Hemoptysis, pleuritic chest pain, dyspnea
The classic PE triad includes hemoptysis, pleuritic chest pain, and dyspnea, though all three are present in only a minority of cases.
Question 4: A patient presents with sudden unilateral leg swelling, warmth, and redness after a long flight. What condition must be ruled out first?
- Cellulitis
- Baker's cyst rupture
- Deep vein thrombosis (Correct answer)
- Lymphedema
Correct answer: Deep vein thrombosis
Deep vein thrombosis must be ruled out first given the risk of embolization to the pulmonary vasculature, which can be fatal.
Question 5: Which of the following medications is a known cause of medication-induced hypoglycemia?
- Metformin alone at therapeutic doses
- Sulfonylureas such as glipizide (Correct answer)
- SGLT2 inhibitors as monotherapy
- DPP-4 inhibitors as monotherapy
Correct answer: Sulfonylureas such as glipizide
Sulfonylureas stimulate insulin secretion regardless of blood glucose level, making hypoglycemia a significant risk even without excess dosing.
Question 6: A 70-year-old male presents with tearing chest pain radiating to the back, unequal blood pressures in both arms, and a widened mediastinum on CXR. The most likely diagnosis is:
- STEMI with posterior extension
- Aortic dissection (Correct answer)
- Cardiac tamponade
- Tension pneumothorax
Correct answer: Aortic dissection
Tearing back pain, blood pressure differential between arms, and widened mediastinum are hallmarks of aortic dissection.
Question 7: Beck's triad — hypotension, muffled heart sounds, and JVD — is classic for which condition?
- Right-sided heart failure
- Tension pneumothorax
- Cardiac tamponade (Correct answer)
- Severe aortic stenosis
Correct answer: Cardiac tamponade
Beck's triad describes cardiac tamponade, where pericardial fluid compresses the heart, impairing filling and reducing cardiac output.
AEMCA Medical Emergencies 3
Which electrolyte abnormality is most associated with peaked T-waves and widened QRS complex on ECG?