FISDAP Medical Emergencies 4

Question 1

A 35-year-old male with a history of depression ingested an unknown quantity of tricyclic antidepressants (TCAs).
He is now unresponsive with a wide QRS complex on ECG.
Which treatment is most immediately indicated?

Accepted Answer

Sodium bicarbonate IV to narrow the QRS

Answer

Activated charcoal via nasogastric tube

Answer

Magnesium sulfate IV for torsades prevention

Answer

Physostigmine IV to reverse anticholinergic effects

Question 2

You respond to a patient with a history of hypertension presenting with a BP of 220/130 mmHg, headache, and visual disturbances. He has no new neurologic deficits. How should this be classified?

Accepted Answer

Hypertensive urgency

Answer

Hypertensive emergency

Answer

Hypertensive crisis with stroke

Answer

Normal variant for this patient

Question 3

A patient with congestive heart failure presents with acute respiratory distress, pink frothy sputum, and crackles bilaterally. SpO2 is 88%. Which intervention provides the most immediate benefit?

Accepted Answer

CPAP at 5–10 cmH2O with high-flow oxygen

Answer

IV nitroglycerin infusion

Answer

Furosemide IV bolus

Answer

Albuterol via nebulizer

Question 4

Which finding differentiates obstructive shock from cardiogenic shock in a trauma patient?

Accepted Answer

Distended neck veins with absent breath sounds unilaterally

Answer

Hypotension and tachycardia

Answer

Pulmonary edema with S3 gallop

Answer

Cool, clammy skin with narrow pulse pressure

Question 5

A patient with known epilepsy is post-ictal and unresponsive. His wife states he seized for approximately 3 minutes and then 'stopped.' He is breathing 12/min with SpO2 of 95%. What is the priority intervention?

Accepted Answer

Place in recovery position and monitor airway

Answer

Administer diazepam IM to prevent recurrence

Answer

Establish IV access and administer dextrose

Answer

Apply 100% O2 via non-rebreather mask immediately

Question 6

When assessing a patient for acute abdomen, which finding is MOST concerning for a surgical emergency requiring rapid transport?

Accepted Answer

Rigid abdomen with rebound tenderness

Answer

Diffuse tenderness with voluntary guarding

Answer

Crampy periumbilical pain with diarrhea

Answer

Right upper quadrant pain after fatty meal

Question 7

A 45-year-old female presents with tearing chest pain radiating to her back, unequal blood pressures in both arms, and a BP of 190/110 mmHg. What is the most likely diagnosis?

Accepted Answer

Aortic dissection

Answer

Acute MI with posterior wall involvement

Answer

Pulmonary embolism

Answer

Spontaneous pneumothorax