Family Practice Exam Acute Care 5

Question 1

A 50-year-old with a history of alcohol use presents with tremors, diaphoresis, and visual hallucinations 36 hours after his last drink. What is the treatment of choice?

Accepted Answer

Benzodiazepines

Answer

Benzodiazepines are first-line for alcohol withdrawal delirium and seizure prevention by cross-reacting at GABA receptors.

Question 2

A 22-year-old presents with fever, purpuric rash, neck stiffness, and shock. What organism is most likely responsible?

Accepted Answer

Neisseria meningitidis

Answer

Neisseria meningitidis causes meningococcemia, characterized by purpuric/petechial rash, meningitis, and septic shock.

Question 3

A patient with a serum acetaminophen level of 250 mcg/mL at 4 hours post-ingestion plots above the Rumack-Matthew nomogram treatment line. What is the antidote?

Accepted Answer

N-acetylcysteine (NAC)

Answer

N-acetylcysteine replenishes glutathione and is the antidote for acetaminophen toxicity when levels exceed the treatment threshold.

Question 4

A 75-year-old on warfarin for AFib presents to the ED with an intracerebral hemorrhage. INR is 4.2. What is the most appropriate reversal strategy?

Accepted Answer

4-factor prothrombin complex concentrate (PCC) plus vitamin K

Answer

4-factor PCC provides rapid, complete reversal of warfarin with smaller volume than FFP, combined with vitamin K for sustained effect.

Question 5

A 38-year-old female presents with pleuritic chest pain, dyspnea, and unilateral leg swelling after a long flight. D-dimer is elevated. What imaging is the gold standard for diagnosis?

Accepted Answer

CT pulmonary angiography

Answer

CT pulmonary angiography (CTPA) is the gold standard for diagnosing pulmonary embolism, offering high sensitivity and specificity.

Family Practice Exam Practice Test

Family Practice Exam Practice Test

Family Practice Exam Acute Care 5