FACEM Patient Assessment and Evaluation 3

Question 1

A 55-year-old diabetic presents with severe flank pain radiating to the groin, nausea, and microscopic hematuria. Which investigation is most appropriate for diagnosis?

Accepted Answer

Non-contrast CT abdomen/pelvis

Answer

Non-contrast CT of the abdomen and pelvis is the gold standard for diagnosing urolithiasis, detecting >95% of stones regardless of composition.

Question 2

During secondary survey of a multi-trauma patient, you identify a Chance fracture on imaging. Which associated injury must be urgently evaluated?

Accepted Answer

Hollow viscus injury

Answer

Chance fractures (flexion-distraction injuries of the thoracolumbar spine) are associated with hollow viscus injuries in up to 50% of cases.

Question 3

A 72-year-old woman on warfarin presents with headache after a minor fall. Her GCS is 15 and neuro exam is normal. Which statement about CT head imaging is most accurate?

Accepted Answer

CT should be performed given anticoagulation and head trauma

Answer

Anticoagulation is an independent indication for CT head after any head trauma due to the significantly elevated risk of intracranial hemorrhage.

Question 4

Which scoring tool is used to risk-stratify patients presenting with upper gastrointestinal bleeding in the emergency department?

Accepted Answer

Glasgow-Blatchford Score

Answer

The Glasgow-Blatchford Score uses clinical and biochemical variables to identify patients with UGIB who require endoscopic intervention or blood transfusion.

Question 5

A 28-year-old pregnant woman at 32 weeks presents with headache, blurred vision, and BP 160/110 mmHg. Which finding on urinalysis would confirm a diagnosis of preeclampsia?

Accepted Answer

Proteinuria ≥300 mg/24h or protein:creatinine ratio ≥0.3

Answer

Preeclampsia is defined as new-onset hypertension (≥140/90) after 20 weeks' gestation with significant proteinuria (≥300 mg/24h) or end-organ damage.

(FACEM) Fellowship of the Australasian College for Emergency Medicine Practice Test

(FACEM) Fellowship of the Australasian College for Emergency Medicine Practice Test

FACEM Patient Assessment and Evaluation 3