FMCLA Acute Care and Emergency Medicine 1 — Questions and Answers
Question 1: A 45-year-old male presents with sudden onset crushing chest pain radiating to the left arm. Which initial diagnostic test is most critical?
- 12-lead ECG (Correct answer)
- Chest X-ray
- Troponin level
- Echocardiogram
Correct answer: 12-lead ECG
A 12-lead ECG is the first-line diagnostic tool for suspected acute MI and should be obtained within 10 minutes of presentation.
Question 2: Which finding on urinalysis is most consistent with a diagnosis of nephrolithiasis in a patient with acute flank pain?
- Proteinuria
- Hematuria (Correct answer)
- Glucosuria
- Pyuria
Correct answer: Hematuria
Hematuria is present in approximately 85% of nephrolithiasis cases and is the hallmark urinalysis finding.
Question 3: A patient presents with anaphylaxis after a bee sting. What is the first-line treatment?
- Diphenhydramine IV
- Epinephrine 0.3 mg IM (Correct answer)
- Methylprednisolone IV
- Albuterol inhaler
Correct answer: Epinephrine 0.3 mg IM
Intramuscular epinephrine in the anterolateral thigh is the first-line and life-saving treatment for anaphylaxis.
Question 4: Which of the following best characterizes a CURB-65 score of 3 in a patient with community-acquired pneumonia?
- Outpatient treatment appropriate
- Consider hospitalization (Correct answer)
- ICU admission required
- No further workup needed
Correct answer: Consider hospitalization
A CURB-65 score of 3 indicates severe pneumonia and warrants hospitalization and consideration of ICU-level care.
Question 5: A patient on warfarin presents with an INR of 8.5 and minor bleeding. What is the most appropriate management?
- Continue warfarin at same dose
- Hold warfarin and give vitamin K orally (Correct answer)
- Administer fresh frozen plasma
- Start heparin bridge therapy
Correct answer: Hold warfarin and give vitamin K orally
For supratherapeutic INR with minor bleeding, holding warfarin and administering oral vitamin K is the standard approach.
Question 6: A 28-year-old presents with a 3-day history of sore throat, fever, and tonsillar exudate. Rapid strep test is positive. Which antibiotic is first-line?
- Amoxicillin (Correct answer)
- Azithromycin
- Ciprofloxacin
- Doxycycline
Correct answer: Amoxicillin
Amoxicillin (or penicillin V) remains the first-line antibiotic for Group A streptococcal pharyngitis due to its efficacy and narrow spectrum.
FMCLA Acute Care and Emergency Medicine 1
A 45-year-old male presents with sudden onset crushing chest pain radiating to the left arm.
Which initial diagnostic test is most critical?