PaEasy Emergency Medicine EOR Exam, ER Final,
ERQUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES |AGRADE
Save
Terms in this set (1044)
,A 59-year-old woman The correct answer is 55%. This estimation is based on
presents to the accident the "rule of 9s". Body surface area is estimated at 9%
and emergency for each arm, the head and neck, anterior surface of
department by ambulance upper torso, anterior surface of lower torso, posterior
with second- and third- surface of upper torso, posterior surface of lower
degree burns to her head torso, anterior surfaces of each leg, posterior
and neck, and the anterior surfaces of each leg and an additional 1% for the groin
surfaces of her upper area for a total of 100%. In this case, 9% for her head
extremities, right leg, and and neck, 9% for the anterior surface of each arm, 9%
trunk including her genital for the anterior surface of her right leg, 9% for her
area. anterior upper torso, 9% for her anterior lower torso,
and 1% for the genital area for a total of 55%.
Question The other answers are incorrect using the estimation
Which of the following by the "rule of 9s".
represents a reasonable
estimation of the extent of
her burns?
Answer Choices
1 36%
2 37%
3 46%
4 45%
5 55%
, refer for emergency endoscopy
A 45-year-old man He should be referred for an emergency upper
presents with endoscopy.
hematemesis. He has had
2 episodes of vomiting This patient is most likely bleeding from a gastric
'coffee-ground'-appearing ulcer. His recent NSAID use, as well as his alcohol and
material; the vomiting tobacco habits, make him at risk for peptic ulcer
began 45 minutes prior to disease. His symptoms of melena and hematemesis,
presentation. Additionally, along with his anemia, make the diagnosis quite
he reports passing black, straightforward.
sticky stools for the past 3
or 4 days. Past medical It appears that this patient is still actively bleeding
history is positive for based on the results of the nasogastric tube irrigation;
occasional headaches; therefore, the priority should be getting the ulcer to
they have been coming stop bleeding. Upper endoscopy should be
more frequenly lately. performed so that the bleeding site can be identified
Social history reveals and treated with electrocautery, coagulation, or
alcohol use (1 case of injection of epinephrine or a sclerosing agent. If the
beer each weekend) and bleeding cannot be stopped with endoscopic
tobacco (1 pack per day). interventions, angiographic embolization should also
Medications include be tried. If these interventions do not succeed, the
ibuprofen as needed for patient has rapid deterioration, or if he requires more
headaches; he has been than 6 units of blood in a 24-hour period, then
taking 800 mg 3 times a emergency surgery may be indicated.
day for the past week. You
place a nasogastric tube The other choices are not the best options for
and find bright red blood immediate management. This individual cannot be
that fails to clear with followed simply with transfusions and serial CBC's
saline irrigation. because he appears to still be actively bleeding.
Hemoglobin is 8.9 g/dL.
Evaluation of his blood Helicobacter pylori infection may very well be playing
pressure and pulse reveals a part in the etiology of this man's ulcer, but
orthostatic changes that evaluation for H. pylori can be done with a biopsy at
resolve with an the time of his endoscopy; it will not help in his
intravenous fluid bolus of immediate management.
500 cc of Lactated
Ringer's solution. What A barium esophagram will not identify actively
, should you do next? bleeding ulcers and cannot treat active bleeding.
Answer Choices While NSAID, alcohol, and tobacco use may have
1 Transfuse 2 units of precipitated this man's GI bleed, counseling about his
packed red blood cells an use of these substances will not sufficiently treat his
immediate bleed.
A 16-year-old male was hit orbital blow out fracture
on the left side of his face B Diplopia is common in an orbital blow out fracture,
by a line drive baseball. due to entrapment of the inferior rectus and inferior
Marked swelling is noted oblique muscles. Loss of infraorbital sensation occurs
externally to the left eye. from disruption or swelling of the infraorbital nerve. A
There was no loss of Le Fort I fracture describes a transverse fracture
consciousness. Upon separating the body of the maxilla from the pterygoid
physical exam, he plate and nasal septum. A Le Fort II fracture describes
complains of diplopia a pyramidal through the central maxilla and hard
during extraocular motion palate. Movement of the hard palate and nose occurs,
testing. Enophthalmos is but not the eyes. A Le Fort III fracture describes a
noted, as well as craniofacial disjunction, wherein the entire face is
decreased sensation of separated from the skull due to fractures of the
the left cheek. Plain x-rays frontozygomatic suture line, across the orbit and
of the face demonstrate through the base of the nose, and ethmoids. The
an air-fluid level in the left entire face shifts, with the globes held in place only
maxillary sinus, and a by the optic nerve.
fracture of the orbit.
Based on this information,
what is the most likely
diagnosis?
A Zygomatic arch fracture
B Orbital blowout fracture
C Le Fort I fracture
D Le Fort II fracture
E Le Fort III fracture
ERQUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES |AGRADE
Save
Terms in this set (1044)
,A 59-year-old woman The correct answer is 55%. This estimation is based on
presents to the accident the "rule of 9s". Body surface area is estimated at 9%
and emergency for each arm, the head and neck, anterior surface of
department by ambulance upper torso, anterior surface of lower torso, posterior
with second- and third- surface of upper torso, posterior surface of lower
degree burns to her head torso, anterior surfaces of each leg, posterior
and neck, and the anterior surfaces of each leg and an additional 1% for the groin
surfaces of her upper area for a total of 100%. In this case, 9% for her head
extremities, right leg, and and neck, 9% for the anterior surface of each arm, 9%
trunk including her genital for the anterior surface of her right leg, 9% for her
area. anterior upper torso, 9% for her anterior lower torso,
and 1% for the genital area for a total of 55%.
Question The other answers are incorrect using the estimation
Which of the following by the "rule of 9s".
represents a reasonable
estimation of the extent of
her burns?
Answer Choices
1 36%
2 37%
3 46%
4 45%
5 55%
, refer for emergency endoscopy
A 45-year-old man He should be referred for an emergency upper
presents with endoscopy.
hematemesis. He has had
2 episodes of vomiting This patient is most likely bleeding from a gastric
'coffee-ground'-appearing ulcer. His recent NSAID use, as well as his alcohol and
material; the vomiting tobacco habits, make him at risk for peptic ulcer
began 45 minutes prior to disease. His symptoms of melena and hematemesis,
presentation. Additionally, along with his anemia, make the diagnosis quite
he reports passing black, straightforward.
sticky stools for the past 3
or 4 days. Past medical It appears that this patient is still actively bleeding
history is positive for based on the results of the nasogastric tube irrigation;
occasional headaches; therefore, the priority should be getting the ulcer to
they have been coming stop bleeding. Upper endoscopy should be
more frequenly lately. performed so that the bleeding site can be identified
Social history reveals and treated with electrocautery, coagulation, or
alcohol use (1 case of injection of epinephrine or a sclerosing agent. If the
beer each weekend) and bleeding cannot be stopped with endoscopic
tobacco (1 pack per day). interventions, angiographic embolization should also
Medications include be tried. If these interventions do not succeed, the
ibuprofen as needed for patient has rapid deterioration, or if he requires more
headaches; he has been than 6 units of blood in a 24-hour period, then
taking 800 mg 3 times a emergency surgery may be indicated.
day for the past week. You
place a nasogastric tube The other choices are not the best options for
and find bright red blood immediate management. This individual cannot be
that fails to clear with followed simply with transfusions and serial CBC's
saline irrigation. because he appears to still be actively bleeding.
Hemoglobin is 8.9 g/dL.
Evaluation of his blood Helicobacter pylori infection may very well be playing
pressure and pulse reveals a part in the etiology of this man's ulcer, but
orthostatic changes that evaluation for H. pylori can be done with a biopsy at
resolve with an the time of his endoscopy; it will not help in his
intravenous fluid bolus of immediate management.
500 cc of Lactated
Ringer's solution. What A barium esophagram will not identify actively
, should you do next? bleeding ulcers and cannot treat active bleeding.
Answer Choices While NSAID, alcohol, and tobacco use may have
1 Transfuse 2 units of precipitated this man's GI bleed, counseling about his
packed red blood cells an use of these substances will not sufficiently treat his
immediate bleed.
A 16-year-old male was hit orbital blow out fracture
on the left side of his face B Diplopia is common in an orbital blow out fracture,
by a line drive baseball. due to entrapment of the inferior rectus and inferior
Marked swelling is noted oblique muscles. Loss of infraorbital sensation occurs
externally to the left eye. from disruption or swelling of the infraorbital nerve. A
There was no loss of Le Fort I fracture describes a transverse fracture
consciousness. Upon separating the body of the maxilla from the pterygoid
physical exam, he plate and nasal septum. A Le Fort II fracture describes
complains of diplopia a pyramidal through the central maxilla and hard
during extraocular motion palate. Movement of the hard palate and nose occurs,
testing. Enophthalmos is but not the eyes. A Le Fort III fracture describes a
noted, as well as craniofacial disjunction, wherein the entire face is
decreased sensation of separated from the skull due to fractures of the
the left cheek. Plain x-rays frontozygomatic suture line, across the orbit and
of the face demonstrate through the base of the nose, and ethmoids. The
an air-fluid level in the left entire face shifts, with the globes held in place only
maxillary sinus, and a by the optic nerve.
fracture of the orbit.
Based on this information,
what is the most likely
diagnosis?
A Zygomatic arch fracture
B Orbital blowout fracture
C Le Fort I fracture
D Le Fort II fracture
E Le Fort III fracture
