FACEM Patient Assessment and Evaluation 5

Question 1

A 25-year-old male presents after a syncopal episode during exercise. ECG shows ST elevation in V1-V2 with a right bundle branch block pattern and normal coronary arteries on previous workup. Which diagnosis is suggested?

Accepted Answer

Brugada syndrome

Answer

Brugada syndrome presents with a Type 1 ECG pattern of coved ST elevation in V1-V2 with RBBB morphology and is associated with sudden cardiac death.

Question 2

When assessing a patient with suspected acute coronary syndrome, which ECG finding indicates the highest immediate risk requiring emergent intervention?

Accepted Answer

New left bundle branch block

Answer

New LBBB in the context of acute chest pain is treated as a STEMI equivalent per current guidelines, requiring emergent reperfusion therapy.

Question 3

During assessment of a patient with suspected stroke, the NIHSS is used. Which domain is NOT assessed by the NIHSS?

Accepted Answer

Memory recall

Answer

The NIHSS does not include formal memory testing; it assesses consciousness, gaze, visual fields, facial palsy, motor limb function, ataxia, sensation, language, dysarthria, and extinction.

Question 4

A 50-year-old male presents with sudden severe eye pain, halos around lights, nausea, and vomiting. Examination reveals a mid-dilated, non-reactive pupil and a hazy cornea. Which condition requires immediate ophthalmologic consultation?

Accepted Answer

Acute angle-closure glaucoma

Answer

Acute angle-closure glaucoma presents with sudden IOP elevation causing corneal edema, mid-dilated fixed pupil, and severe pain and must be treated urgently to prevent vision loss.

Question 5

Which component of the ABCDE primary survey approach addresses the identification and control of life-threatening external hemorrhage in current ATLS guidelines?

Accepted Answer

Catastrophic hemorrhage control before A

Answer

Current ATLS (10th edition) adds a 'C' for Catastrophic hemorrhage control before Airway, recognizing exsanguination as the most immediately survivable cause of death.

(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 5