Emergency Medicine & Critical Care Flashcards

According to HAAD/DOH guidelines, what is the recommended first-line treatment for anaphylaxis in adults?

Answer: Intramuscular epinephrine 0.3–0.5 mg (1:1000)

Intramuscular epinephrine 0.3–0.5 mg of 1:1000 solution into the anterolateral thigh is the first-line treatment for anaphylaxis due to its rapid absorption and life-saving effect.

A patient presents with a Glasgow Coma Scale (GCS) score of 8. What does this indicate?

Answer: Severe brain injury requiring immediate airway protection

A GCS of 8 or below indicates severe brain injury and is the threshold at which airway protection through intubation is typically required.

Which ECG finding is most consistent with ST-elevation myocardial infarction (STEMI) requiring immediate intervention?

Answer: New left bundle branch block (LBBB) with ST changes

A new left bundle branch block with associated ST changes is treated as a STEMI equivalent and requires immediate reperfusion therapy per international and UAE cardiac care protocols.

In a patient with diabetic ketoacidosis (DKA), which electrolyte must be closely monitored and replaced before starting insulin therapy?

Answer: Potassium

Potassium must be checked and corrected to ≥3.5 mEq/L before insulin is given, as insulin drives potassium intracellularly and can cause life-threatening hypokalemia.

What is the correct compression-to-ventilation ratio for adult cardiopulmonary resuscitation (CPR) with a single rescuer?

Answer: 30:2

Current AHA and ILCOR guidelines recommend a 30:2 compression-to-ventilation ratio for single-rescuer adult CPR to minimize interruptions to chest compressions.

A patient in septic shock is not responding to 30 mL/kg of IV crystalloid. What is the next recommended step according to Surviving Sepsis Campaign guidelines?

Answer: Initiate vasopressor therapy with norepinephrine

Norepinephrine is the first-choice vasopressor when fluids fail to restore mean arterial pressure ≥65 mmHg in septic shock.

Which of the following is the primary endpoint for evaluating adequate fluid resuscitation in a trauma patient?

Answer: Urine output of 0.5–1 mL/kg/hour

A urine output of 0.5–1 mL/kg/hour is a reliable clinical indicator of adequate organ perfusion and fluid resuscitation in trauma patients.

Which ventilator strategy is recommended for patients with Acute Respiratory Distress Syndrome (ARDS) to minimize ventilator-induced lung injury?

Answer: Low tidal volume (6 mL/kg ideal body weight) with high PEEP

Lung-protective ventilation using low tidal volumes of 6 mL/kg ideal body weight and appropriate PEEP reduces barotrauma and improves outcomes in ARDS.

A patient arrives in the emergency department with suspected opioid overdose. Which medication should be administered immediately?

Answer: Naloxone 0.4–2 mg IV/IM/IN

Naloxone is a competitive opioid antagonist that rapidly reverses opioid-induced respiratory depression and altered consciousness.

In the trauma primary survey, what does the 'C' in the modified ABCDE approach stand for?

Answer: Catastrophic hemorrhage control

In the modified ABCDE approach, 'C' stands for Catastrophic hemorrhage control, which takes priority even before airway management in major trauma.

Which of the following is a contraindication to thrombolytic therapy in ischemic stroke?

Answer: Recent intracranial surgery within 3 months

Recent intracranial surgery, severe head trauma, or prior stroke within 3 months are absolute contraindications to thrombolytic therapy due to the risk of hemorrhagic transformation.

What is the initial energy dose recommended for defibrillation of ventricular fibrillation using a biphasic defibrillator?

Answer: 150–200 joules

Biphasic defibrillators are typically used at 150–200 joules for the initial shock in ventricular fibrillation, which is effective and reduces myocardial damage compared to monophasic devices.

Which of the following correctly describes the AVPU scale used in emergency neurological assessment?

Answer: Alert, Verbal, Pain, Unresponsive

The AVPU scale assesses level of consciousness as Alert, responds to Verbal stimuli, responds to Pain stimuli, or Unresponsive.

A patient with known chronic kidney disease presents with peaked T waves, widened QRS, and a serum potassium of 7.2 mEq/L. What is the FIRST priority intervention?

Answer: Give calcium gluconate IV to stabilize the cardiac membrane

Calcium gluconate is the first-line intervention in severe hyperkalemia with ECG changes because it immediately stabilizes the cardiac membrane and prevents arrhythmia.