NCCPA Emergency Medicine 3

Question 1

A 55-year-old diabetic presents with painless lower extremity ulcer and crepitus on palpation. Imaging shows gas in soft tissues. What is the immediate management?

Accepted Answer

Emergent surgical debridement plus broad-spectrum antibiotics

Answer

Necrotizing fasciitis requires emergent surgical debridement as the definitive treatment; antibiotics alone are insufficient and delay surgery increases mortality.

Question 2

What is the first-line treatment for anaphylaxis?

Accepted Answer

Epinephrine 0.3mg IM in the anterolateral thigh

Answer

Epinephrine IM (0.3mg of 1:1000 solution) in the anterolateral thigh is the first and most critical intervention for anaphylaxis.

Question 3

A 35-year-old presents with sudden-onset monocular vision loss, painless, described as a 'curtain coming down.' Fundoscopy shows cherry-red spot with pale retina. What is the diagnosis?

Accepted Answer

Central retinal artery occlusion

Answer

Central retinal artery occlusion presents with sudden painless monocular vision loss, cherry-red spot at the fovea, and diffuse retinal pallor.

Question 4

Which of the following best describes the Beck's triad associated with cardiac tamponade?

Accepted Answer

Hypotension, muffled heart sounds, jugular venous distension

Answer

Beck's triad consists of hypotension, muffled heart sounds, and jugular venous distension due to pericardial fluid compressing cardiac chambers.

Question 5

A patient presents after drowning with oxygen saturation of 84% on room air. CXR shows diffuse bilateral infiltrates. What syndrome is developing?

Accepted Answer

Acute Respiratory Distress Syndrome (ARDS)

Answer

Near-drowning can cause ARDS characterized by hypoxemia, bilateral infiltrates, and reduced lung compliance from surfactant washout and inflammation.

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

NCCPA Emergency Medicine 3