FMCLA Acute Care and Emergency Medicine 2

Question 1

Which clinical feature best differentiates bacterial sinusitis from viral upper respiratory infection?

Accepted Answer

Symptoms worsening after initial improvement (double sickening)

Answer

Double sickening — initial improvement followed by worsening — is a hallmark feature suggesting bacterial superinfection in sinusitis.

Question 2

A patient presents with suspected deep vein thrombosis. Which scoring system should be applied before ordering imaging?

Accepted Answer

Wells criteria

Answer

The Wells criteria stratify pretest probability for DVT and guide the decision to perform D-dimer testing or duplex ultrasound.

Question 3

Which of the following is the most appropriate initial management for a simple febrile seizure in a 2-year-old?

Accepted Answer

Supportive care and fever management

Answer

Simple febrile seizures are self-limiting and benign; supportive care and antipyretics are appropriate without neuroimaging or anticonvulsants.

Question 4

A patient with known COPD presents in acute exacerbation with SpO2 of 84%. What oxygen delivery target is appropriate?

Accepted Answer

SpO2 88–92%

Answer

COPD patients should be targeted to SpO2 88–92% to avoid hypercapnia worsening due to blunted hypoxic drive.

Question 5

Which test is most sensitive for detecting acute pulmonary embolism?

Accepted Answer

CT pulmonary angiography (CTPA)

Answer

CT pulmonary angiography is the gold-standard imaging modality for diagnosing PE with high sensitivity and specificity.

FMCLA - Family Medicine Certification Longitudinal Assessment Practice Test