Family Practice Exam Acute Care 4

Question 1

A 25-year-old male is brought in after a motor vehicle accident with BP 80/50, HR 130, and distended neck veins. Breath sounds are equal bilaterally. What is the most likely diagnosis?

Accepted Answer

Cardiac tamponade

Answer

Beck's triad of hypotension, distended neck veins, and muffled heart sounds suggests cardiac tamponade.

Question 2

A 60-year-old presents with sudden vision loss in one eye described as a 'curtain coming down.' What is the most likely diagnosis?

Accepted Answer

Retinal detachment

Answer

Painless monocular vision loss described as a descending curtain is the classic presentation of retinal detachment.

Question 3

A patient with liver cirrhosis presents with fever, abdominal pain, and ascites with PMN count >250 cells/mm³ on paracentesis. What is the first-line treatment?

Accepted Answer

IV cefotaxime

Answer

Spontaneous bacterial peritonitis is treated with IV cefotaxime (third-generation cephalosporin) as first-line therapy.

Question 4

A 3-year-old is brought to the ED with drooling, high fever, muffled voice, and appears anxious sitting in the 'sniffing position.' What is the most important next step?

Accepted Answer

Immediate otolaryngology and anesthesia consultation for airway management

Answer

Epiglottitis is a life-threatening emergency requiring immediate airway securing in a controlled setting with surgical backup.

Question 5

A 68-year-old presents with sudden onset of atrial fibrillation with RVR (HR 145 bpm) and is hemodynamically stable. What is the preferred acute rate-control agent?

Accepted Answer

Diltiazem IV

Answer

IV diltiazem (calcium channel blocker) provides rapid rate control in hemodynamically stable atrial fibrillation with rapid ventricular response.

Family Practice Exam Practice Test

Family Practice Exam Practice Test

Family Practice Exam Acute Care 4