DOH Emergency Medicine & Critical Care 1 — Questions and Answers
Question 1: According to HAAD/DOH guidelines, what is the recommended first-line treatment for anaphylaxis in adults?
- Intravenous hydrocortisone 200 mg
- Intramuscular epinephrine 0.3–0.5 mg (1:1000) (Correct answer)
- Intravenous diphenhydramine 50 mg
- Subcutaneous epinephrine 0.1 mg (1:10000)
Correct answer: Intramuscular epinephrine 0.3–0.5 mg (1:1000)
Intramuscular epinephrine 0.3–0.5 mg of 1:1000 solution into the anterolateral thigh is the first-line treatment for anaphylaxis due to its rapid absorption and life-saving effect.
Question 2: A patient presents with a Glasgow Coma Scale (GCS) score of 8. What does this indicate?
- Mild traumatic brain injury requiring observation
- Severe brain injury requiring immediate airway protection (Correct answer)
- Moderate brain injury manageable with supplemental oxygen
- Normal neurological status in a sedated patient
Correct answer: Severe brain injury requiring immediate airway protection
A GCS of 8 or below indicates severe brain injury and is the threshold at which airway protection through intubation is typically required.
Question 3: Which ECG finding is most consistent with ST-elevation myocardial infarction (STEMI) requiring immediate intervention?
- ST depression ≥ 1 mm in two contiguous leads
- ST elevation ≥ 1 mm in two contiguous limb leads
- T-wave inversion in leads V1–V3
- New left bundle branch block (LBBB) with ST changes (Correct answer)
Correct answer: New left bundle branch block (LBBB) with ST changes
A new left bundle branch block with associated ST changes is treated as a STEMI equivalent and requires immediate reperfusion therapy per international and UAE cardiac care protocols.
Question 4: In a patient with diabetic ketoacidosis (DKA), which electrolyte must be closely monitored and replaced before starting insulin therapy?
- Sodium
- Potassium (Correct answer)
- Calcium
- Magnesium
Correct answer: Potassium
Potassium must be checked and corrected to ≥3.5 mEq/L before insulin is given, as insulin drives potassium intracellularly and can cause life-threatening hypokalemia.
Question 5: What is the correct compression-to-ventilation ratio for adult cardiopulmonary resuscitation (CPR) with a single rescuer?
- 15:2
- 30:2 (Correct answer)
- 5:1
- 20:2
Correct answer: 30:2
Current AHA and ILCOR guidelines recommend a 30:2 compression-to-ventilation ratio for single-rescuer adult CPR to minimize interruptions to chest compressions.
Question 6: A patient in septic shock is not responding to 30 mL/kg of IV crystalloid. What is the next recommended step according to Surviving Sepsis Campaign guidelines?
- Administer a second bolus of 30 mL/kg crystalloid
- Initiate vasopressor therapy with norepinephrine (Correct answer)
- Begin dopamine infusion at low dose
- Transfuse packed red blood cells
Correct answer: Initiate vasopressor therapy with norepinephrine
Norepinephrine is the first-choice vasopressor when fluids fail to restore mean arterial pressure ≥65 mmHg in septic shock.
Question 7: Which of the following is the primary endpoint for evaluating adequate fluid resuscitation in a trauma patient?
- Systolic blood pressure > 90 mmHg
- Urine output of 0.5–1 mL/kg/hour (Correct answer)
- Heart rate < 100 beats/minute
- Serum lactate > 4 mmol/L
Correct answer: Urine output of 0.5–1 mL/kg/hour
A urine output of 0.5–1 mL/kg/hour is a reliable clinical indicator of adequate organ perfusion and fluid resuscitation in trauma patients.
DOH Emergency Medicine & Critical Care 1
According to HAAD/DOH guidelines, what is the recommended first-line treatment for anaphylaxis in adults?