NZREX Emergency and Acute Medicine

Question 1

In NZ emergency medicine, what is the ABCDE approach to assessing a critically unwell patient?

Accepted Answer

Airway, Breathing, Circulation, Disability (neurological), Exposure — a systematic priority-based assessment

Answer

Assess, Bandage, Compress, Defibrillate, Evacuate

Answer

Antibiotics, Blood tests, CT scan, Diagnosis, Examination

Answer

Awareness, Balance, Coordination, Dexterity, Endurance

Question 2

A patient presents to a NZ emergency department with chest pain. What is the first-line investigation to rule out an acute myocardial infarction?

Accepted Answer

12-lead ECG — should be performed within 10 minutes of arrival

Answer

Chest X-ray

Answer

CT coronary angiography

Answer

Echocardiogram

Question 3

In NZ, what is the Glasgow Coma Scale (GCS) and what are its three components?

Accepted Answer

A neurological assessment scoring Eye opening (1-4), Verbal response (1-5), and Motor response (1-6) — total range 3 to 15

Answer

A measure of blood glucose levels

Answer

A scoring system for wound severity

Answer

A classification of seizure types

Question 4

A patient presents to a NZ ED with anaphylaxis. What is the first-line drug treatment?

Accepted Answer

Intramuscular adrenaline (epinephrine) 0.5 mg (1:1000) into the anterolateral thigh

Answer

Intravenous hydrocortisone 200 mg

Answer

Oral antihistamine (cetirizine 10 mg)

Answer

Intravenous salbutamol 250 mcg

Question 5

In NZ emergency practice, what is the recommended approach to managing a patient with acute asthma exacerbation?

Accepted Answer

High-flow oxygen, nebulised salbutamol, ipratropium bromide, oral prednisolone or IV hydrocortisone, and reassess response

Answer

Inhaled corticosteroids only

Answer

Antibiotics and complete bed rest

Answer

IV aminophylline as first-line treatment

Question 6

What is the NZ protocol for managing a patient presenting with acute stroke symptoms?

Accepted Answer

Urgent CT brain to differentiate ischaemic from haemorrhagic stroke, with consideration of thrombolysis (tPA) within 4.5 hours for eligible ischaemic strokes

Answer

Start aspirin immediately without imaging

Answer

Perform a lumbar puncture as the first investigation

Answer

Observe for 24 hours before any intervention