Family Practice Exam Acute Care 3 — Questions and Answers
Question 1: A 6-year-old presents with inspiratory stridor, barking cough, and low-grade fever. Which treatment is most appropriate?
- IV antibiotics
- Nebulized racemic epinephrine and dexamethasone (Correct answer)
- Heliox only
- Immediate intubation
Correct answer: Nebulized racemic epinephrine and dexamethasone
Croup (viral laryngotracheobronchitis) is treated with dexamethasone and nebulized epinephrine for moderate-to-severe cases.
Question 2: A 45-year-old with known COPD presents with worsening dyspnea, decreased breath sounds on the left, and tracheal deviation to the right. What is the immediate intervention?
- Obtain chest X-ray
- Start BiPAP
- Needle decompression (Correct answer)
- Administer bronchodilators
Correct answer: Needle decompression
Tension pneumothorax with hemodynamic compromise requires immediate needle decompression without waiting for imaging.
Question 3: A patient presents with weakness, hyperkalemia (K+ 7.2 mEq/L), and peaked T-waves on ECG. What is the first medication to administer?
- Sodium bicarbonate
- Calcium gluconate (Correct answer)
- Furosemide
- Kayexalate
Correct answer: Calcium gluconate
Calcium gluconate stabilizes the cardiac membrane and is the first-line treatment to prevent life-threatening arrhythmias in severe hyperkalemia.
Question 4: A 32-year-old female 20 weeks pregnant presents with BP 160/110 mmHg, headache, and 3+ proteinuria. What is the drug of choice for acute blood pressure management?
- ACE inhibitor
- IV labetalol or hydralazine (Correct answer)
- Furosemide
- Oral nifedipine XL
Correct answer: IV labetalol or hydralazine
IV labetalol or hydralazine is first-line for acute severe hypertension in pregnancy; ACE inhibitors are contraindicated.
Question 5: A 55-year-old male presents with acute onset of severe flank pain radiating to the groin with hematuria. What is the most likely diagnosis?
- Appendicitis
- Nephrolithiasis (Correct answer)
- Aortic aneurysm
- Ectopic pregnancy
Correct answer: Nephrolithiasis
Colicky flank pain radiating to the groin with hematuria is classic for ureteral calculi (kidney stones).
Question 6: A patient presents with confusion, fever, jaundice, renal failure, and thrombocytopenia after starting a new antibiotic. What is the most likely diagnosis?
- Sepsis
- Thrombotic thrombocytopenic purpura (Correct answer)
- DIC
- Hemolytic uremic syndrome
Correct answer: Thrombotic thrombocytopenic purpura
The pentad of fever, microangiopathic hemolytic anemia, thrombocytopenia, renal failure, and neurological symptoms defines TTP.
Question 7: Which ECG finding is most specific for hyperacute ST-elevation MI of the anterior wall?
- ST elevation in leads II, III, aVF
- ST elevation in leads V1-V4 (Correct answer)
- Diffuse ST elevation with PR depression
- ST elevation in leads I and aVL only
Correct answer: ST elevation in leads V1-V4
ST elevation in the precordial leads V1-V4 indicates LAD territory (anterior wall) MI.
Family Practice Exam Acute Care 3
A 6-year-old presents with inspiratory stridor, barking cough, and low-grade fever.
Which treatment is most appropriate?