DHA Emergency Medical Services 2

Question 1

A 25-year-old male is brought to the ED after a road traffic accident. He is unresponsive, BP 70/40 mmHg, HR 130 bpm, and has absent breath sounds on the right side with tracheal deviation to the left. What is the immediate management?

Accepted Answer

Immediate needle thoracostomy in the right 2nd intercostal space, midclavicular line

Answer

This is a tension pneumothorax — a life-threatening emergency requiring immediate needle decompression. Tracheal deviation away from the affected side, absent breath sounds, and hemodynamic instability are classic signs. Do not wait for imaging.

Question 2

An adult patient in cardiac arrest is receiving CPR. After the second defibrillation shock, which medication should be administered next according to ACLS guidelines?

Accepted Answer

Epinephrine 1mg IV every 3–5 minutes

Answer

Per ACLS guidelines, epinephrine 1mg IV should be given as soon as possible during cardiac arrest. For shockable rhythms (VF/pVT), epinephrine is given after the second shock. It is repeated every 3–5 minutes throughout resuscitation.

Question 3

A 60-year-old male presents with sudden onset severe headache described as 'the worst headache of my life.' Neurological exam is normal. CT head is negative. What is the next most important step?

Accepted Answer

Lumbar puncture

Answer

A 'thunderclap' headache with normal CT requires lumbar puncture to rule out subarachnoid hemorrhage (SAH). CT misses ~2–5% of SAH (especially early presentations). LP looks for xanthochromia (yellow discoloration of CSF), which indicates prior bleeding.

Question 4

In the ED, a patient presents with anaphylaxis with urticaria, angioedema, and bronchospasm after a bee sting. What is the first-line treatment?

Accepted Answer

IM epinephrine 0.3–0.5mg (1:1000) in the outer thigh

Answer

IM epinephrine (0.3–0.5mg of 1:1000 concentration) in the anterolateral thigh is the first-line and most critical treatment for anaphylaxis. It reverses bronchospasm, hypotension, and angioedema. All other treatments are adjuncts.

Question 5

A patient presents with heat stroke: core temperature 41.5°C, confusion, and hot dry skin after outdoor work in Dubai summer. What is the most effective cooling method?

Accepted Answer

Ice water immersion or aggressive evaporative cooling

Answer

Classic heat stroke is a medical emergency requiring rapid core cooling. Ice water immersion achieves the fastest cooling rate (0.2°C/min). Evaporative cooling (wetting skin + fanning) is also effective. Target core temperature <39°C within 30 minutes. Antipyretics are ineffective as heat stroke is not fever — it is thermoregulatory failure.

DHA - Dubai Health Authority Practice Test

DHA - Dubai Health Authority Practice Test

DHA Emergency Medical Services 2