COMLEX-USA Surgery and Emergency Medicine

Question 1

A patient presents with sudden onset of tearing chest pain radiating to the back, with unequal blood pressures in bilateral arms. The most likely diagnosis is:

Accepted Answer

Aortic dissection

Answer

Aortic dissection classically presents with sudden severe tearing or ripping chest/back pain and pulse or blood pressure differentials between extremities.

Question 2

In the initial management of an acute burn patient, fluid resuscitation in the first 24 hours is guided by which formula?

Accepted Answer

Parkland formula

Answer

The Parkland formula (4 mL × weight in kg × % TBSA burned) with lactated Ringer's guides IV fluid resuscitation in major burns in the first 24 hours.

Question 3

Beck's triad (hypotension, muffled heart sounds, JVD) is the classic presentation of which emergency?

Accepted Answer

Cardiac tamponade

Answer

Beck's triad (hypotension, muffled/distant heart sounds, and JVD) is the hallmark of cardiac tamponade from pericardial fluid compressing the heart.

Question 4

A 35-year-old woman presents with right lower quadrant pain, fever, anorexia, and elevated WBC. Rebound tenderness at McBurney's point is present. Diagnosis is:

Accepted Answer

Acute appendicitis

Answer

Acute appendicitis classically presents with periumbilical pain migrating to the RLQ (McBurney's point), fever, anorexia, and leukocytosis.

Question 5

During ATLS primary survey, which is assessed as part of the 'C' component of ABCDE?

Accepted Answer

Circulation and hemorrhage control

Answer

In ATLS, C stands for Circulation with hemorrhage control — including assessment of blood pressure, pulses, and control of external bleeding.

COMLEX-USA Practice Test

COMLEX-USA Practice Test

COMLEX-USA Surgery and Emergency Medicine