PANRE Emergency Medicine 3

Question 1

A 60-year-old female presents with acute onset atrial fibrillation with rapid ventricular response and hypotension (BP 80/50). What is the immediate treatment?

Accepted Answer

Synchronized DC cardioversion

Answer

Unstable atrial fibrillation with hemodynamic compromise requires immediate synchronized cardioversion regardless of duration.

Question 2

A 3-year-old child is brought in unresponsive after being found in a backyard pool. After 2 minutes of CPR, a pulse is restored. Temperature is 32°C. What management is critical?

Accepted Answer

Passive rewarming and supportive care with close neurologic monitoring

Answer

In pediatric drowning with restored circulation and mild hypothermia, passive rewarming and supportive care with neurologic monitoring is appropriate; active cooling is not indicated.

Question 3

A 50-year-old diabetic presents with right lower quadrant pain, fever, and nausea for 2 days. CT shows a perforated appendix with localized abscess. What is the best initial management?

Accepted Answer

IV antibiotics and interventional radiology drainage

Answer

A walled-off periappendiceal abscess is best managed initially with IV antibiotics and percutaneous drainage, with interval appendectomy planned later.

Question 4

A 35-year-old presents after a bee sting with urticaria, hypotension, and stridor. After IM epinephrine, blood pressure improves but stridor persists. What is the next step?

Accepted Answer

Repeat epinephrine and prepare for definitive airway management

Answer

Persistent stridor after epinephrine in anaphylaxis signals imminent airway obstruction; repeat epinephrine and prepare for intubation or surgical airway.

Question 5

A 28-year-old male presents with a painful, tender, fluctuant perirectal mass. He has no fever or signs of systemic infection. What is the appropriate ED treatment?

Accepted Answer

Incision and drainage in the ED

Answer

A simple perirectal abscess without systemic involvement should be incised and drained in the ED without delay.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Emergency Medicine 3