ROSH REVIEW Emergency Medicine
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✔ Complete Exam Questions covering major concepts
✔ Correct Answers with Detailed Explanations for deeper understanding
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✔ Latest Updated Version for reliable exam preparation
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This study guide helps students simplify complex topics, identify key concepts quickly, and
strengthen exam confidence. By practicing with structured questions and reviewing detailed
answers, you can improve retention and boost your chances of achieving higher scores.
🎯 Perfect For
,• Final exam preparation
• Midterm exam revision
• Weekly study sessions
• Practicing exam-style questions
• Strengthening knowledge before tests
📘 A reliable and effective study companion for students who want structured practice,
clear explanations, and stronger exam performance.
A 14-year-old boy presents complaining of intense pruritus in his groin, axillae,
and between his fingers after returning home from summer camp 1 week ago. He
reports several other campers had similar symptoms. On exam, you note
excoriations in the inguinal region and axillae surrounding scattered,
erythematous papules. Which of the following is the most appropriate treatment?
Ketoconazole
Lindane
Permethrin
Prednisone
Correct Answer ( C )
Explanation:
This patient has scabies; a pruritic dermatitis caused by cutaneous infection with the
mite Sarcoptes scabei, var hominis. Scabies is spread by skin-to-skin contact and
should be considered in patients with generalized pruritus, especially when exposure to
others with similar symptoms is reported. The rash of scabies involves papules, which
are often excoriated. Burrows are pathognomonic but not uniformly present. Unless
previously infected, pruritus generally takes 3-6 weeks to develop because symptoms
are due to delayed (Type IV) sensitivity reaction. The pruritus is classically worse at
night and affects the web spaces of the fingers, flexor aspect of the wrists, axillae, groin,
nipples, and the periumbilical region. Except in cases involving an immunocompromised
host, the scalp and face are generally spared. Diagnosis is clinical but can be confirmed
by placing scrapings collected with a #15 blade scalpel in mineral oil for microscopic
examination. The treatment of choice for primary scabies infection is the application of
topical scabicidal agents, with repeat application in 7 days. The treatment of choice is
permethrin 5% lotion. Individuals affected by scabies should avoid skin-to-skin contact
with others. Patients with typical scabies may return to school or work 24 hours after the
first treatment.
Should family members of an infected individual also be treated for scabies?
Yes, family members and sexual contacts.
Scabies
Sarcoptes scabiei
Pruritic rash worse at night
Linear burrows
,Interdigital spaces of hands/feet, penis, breasts
Permethrin (first line)
Ivermectin
**head and back are sparred
(head involved in children)
An 18-month-old boy presents to the emergency department with worsening
shortness of breath. The parents report he has had a cough, runny nose, and
fussiness for the past five days. On exam, the patient demonstrates subcostal
retractions, tachypnea, and diffuse wheezing. The patient is given an albuterol
nebulizer treatment without any improvement of his wheezing. Chest X-ray does
not show any abnormality. Which of the following organisms is the most likely
cause of his symptoms?
Bordetella pertussis
Haemophilus influenzae
Parainfluenza virus
Respiratory syncytial virus
Correct Answer ( D )
Explanation:
The patient has bronchiolitis, which is the most common lower respiratory tract infection
in patients less than two years of age. It remains the leading cause for hospitalization in
infants under one year of age. Bronchiolitis is most commonly caused by respiratory
syncytial virus (RSV), but may be caused by other viral agents. Bronchiolitis is
inflammation of the lower respiratory tract, which involves edema, epithelial cell
necrosis, bronchospasm, and increased mucus production. The resultant lower airway
obstruction causes increased work of breathing and wheezing. Bronchiolitis is a clinical
diagnosis based on age under two years old, rhinorrhea, tachypnea, and wheezing.
Unlike asthma or reactive airway disease, there is often no significant improvement with
albuterol. There is often a history of several days of upper respiratory symptoms, such
as rhinorrhea, mild cough, and mild fever. Rapid antigen tests, blood work, and
radiographs are not usually needed. Radiographs may demonstrate hyperinflation and
atelectasis, but do not show any focal infiltrates like with pneumonia. Bronchiolitis is
usually self-limited, with respiratory status typically improving over 2-5 days.
Management involves supportive care.
Bronchiolitis
What months of the year contain the peak incidence of RSV in North America?
November to March.
A 76-year-old man presents to the emergency department with shortness of
breath and lightheadedness. Vital signs include blood pressure 70/56 mm Hg,
heart rate 124 beats/minute, respiratory rate 22 breaths/minute, and temperature
37.6°C. He has distended neck veins and occasional dropped radial beats. His
lungs are clear to auscultation, but his heart sounds are distant. He has some
fullness to palpation of the right upper quadrant of his abdomen. Which of the
following is the most appropriate diagnostic test?
Bedside echocardiography
, Chest radiograph
Computed tomography angiogram of the chest
Electrocardiogram
Correct Answer ( A )
Explanation:
This patient presents with a clinical picture consistent with obstructive shock. His
distended neck veins, full right upper quadrant, muffled heart sounds, and hypotension
are all consistent with pericardial tamponade. A pericardial sac slowly accumulating fluid
can stretch without obstructing cardiac function. Tamponade occurs when rapid fluid
accumulation results in elevated pressures that inhibit venous return. This is a dynamic
process over the course of the cardiac cycle, therefore bedside echocardiography is the
diagnostic test of choice. Fluid around the heart with evidence of right atrial
compression and right ventricular diastolic collapse are diagnostic of pericardial
tamponade.
Pericardial Effusion
What is the emergent treatment of pericardial tamponade?
Pericardiocentesis.
An 8-year-old African-American girl with a history of sickle cell anemia presents
with diffuse pain consistent with an acute sickle cell pain crisis. While in the
emergency department, she develops acute onset headache, right sided facial
droop and right arm weakness. A CT scan confirms the diagnosis. Which of the
following is the next best step in management?
Alteplase
Exchange transfusion
MRI brain
Tranexamic acid
Correct Answer ( B )
Explanation:
Cerebrovascular events are a potential complication of sickle cell disease. This patient
developed symptoms concerning for acute ischemic stroke. For pediatric patients with
acute ischemic stroke in the setting of sickle cell disease, exchange transfusion is the
treatment of choice. Transfusion goals include decreasing hemoglobin S levels to less
than 30% and obtaining a total hemoglobin level of 10 g/dL. For adults with acute
ischemic stroke in the setting of sickle cell disease, consider tissue plasminogen
activator (tPA). tPA is not indicated or approved for use in pediatric patients
Tranexamic acid (D) is an antifibrinolytic agent used in the management of hemorrhage.
Indications include acute traumatic hemorrhage, intraoperative blood loss, and obstetric
hemorrhage. Tranexamic acid is not used for ischemic events
Manage Sickle Cell
What is the most common bacterial cause of acute chest syndrome in adults with
sickle cell disease?
Atypical bacteria such as Chlamydia pneumoniae, Mycoplasma pneumoniae,
Mycoplasma hominis.
Premium General Exam Study Guide –
Complete Questions with Correct Detailed
Answers
⭐ Brand New Version | Exam-Focused | Designed for High
Scores
Take your exam preparation to the next level with this Premium General Exam Study Guide.
This powerful resource is designed to help students review faster, understand key concepts
clearly, and perform confidently in exams.
Inside this guide, you will find complete exam questions paired with correct, detailed
answers that explain the reasoning behind each response. The structured format allows you to
focus on important and frequently tested topics, helping you study efficiently and effectively.
🔥 Key Highlights
✔ Complete Exam Questions covering major concepts
✔ Correct Answers with Detailed Explanations for deeper understanding
✔ Exam-Focused Content based on commonly tested material
✔ Well-Organized Format for quick and effective revision
✔ Latest Updated Version for reliable exam preparation
✔ Ideal for Fast Review and Last-Minute Study
🚀 Why Students Prefer This Guide
This study guide helps students simplify complex topics, identify key concepts quickly, and
strengthen exam confidence. By practicing with structured questions and reviewing detailed
answers, you can improve retention and boost your chances of achieving higher scores.
🎯 Perfect For
,• Final exam preparation
• Midterm exam revision
• Weekly study sessions
• Practicing exam-style questions
• Strengthening knowledge before tests
📘 A reliable and effective study companion for students who want structured practice,
clear explanations, and stronger exam performance.
A 14-year-old boy presents complaining of intense pruritus in his groin, axillae,
and between his fingers after returning home from summer camp 1 week ago. He
reports several other campers had similar symptoms. On exam, you note
excoriations in the inguinal region and axillae surrounding scattered,
erythematous papules. Which of the following is the most appropriate treatment?
Ketoconazole
Lindane
Permethrin
Prednisone
Correct Answer ( C )
Explanation:
This patient has scabies; a pruritic dermatitis caused by cutaneous infection with the
mite Sarcoptes scabei, var hominis. Scabies is spread by skin-to-skin contact and
should be considered in patients with generalized pruritus, especially when exposure to
others with similar symptoms is reported. The rash of scabies involves papules, which
are often excoriated. Burrows are pathognomonic but not uniformly present. Unless
previously infected, pruritus generally takes 3-6 weeks to develop because symptoms
are due to delayed (Type IV) sensitivity reaction. The pruritus is classically worse at
night and affects the web spaces of the fingers, flexor aspect of the wrists, axillae, groin,
nipples, and the periumbilical region. Except in cases involving an immunocompromised
host, the scalp and face are generally spared. Diagnosis is clinical but can be confirmed
by placing scrapings collected with a #15 blade scalpel in mineral oil for microscopic
examination. The treatment of choice for primary scabies infection is the application of
topical scabicidal agents, with repeat application in 7 days. The treatment of choice is
permethrin 5% lotion. Individuals affected by scabies should avoid skin-to-skin contact
with others. Patients with typical scabies may return to school or work 24 hours after the
first treatment.
Should family members of an infected individual also be treated for scabies?
Yes, family members and sexual contacts.
Scabies
Sarcoptes scabiei
Pruritic rash worse at night
Linear burrows
,Interdigital spaces of hands/feet, penis, breasts
Permethrin (first line)
Ivermectin
**head and back are sparred
(head involved in children)
An 18-month-old boy presents to the emergency department with worsening
shortness of breath. The parents report he has had a cough, runny nose, and
fussiness for the past five days. On exam, the patient demonstrates subcostal
retractions, tachypnea, and diffuse wheezing. The patient is given an albuterol
nebulizer treatment without any improvement of his wheezing. Chest X-ray does
not show any abnormality. Which of the following organisms is the most likely
cause of his symptoms?
Bordetella pertussis
Haemophilus influenzae
Parainfluenza virus
Respiratory syncytial virus
Correct Answer ( D )
Explanation:
The patient has bronchiolitis, which is the most common lower respiratory tract infection
in patients less than two years of age. It remains the leading cause for hospitalization in
infants under one year of age. Bronchiolitis is most commonly caused by respiratory
syncytial virus (RSV), but may be caused by other viral agents. Bronchiolitis is
inflammation of the lower respiratory tract, which involves edema, epithelial cell
necrosis, bronchospasm, and increased mucus production. The resultant lower airway
obstruction causes increased work of breathing and wheezing. Bronchiolitis is a clinical
diagnosis based on age under two years old, rhinorrhea, tachypnea, and wheezing.
Unlike asthma or reactive airway disease, there is often no significant improvement with
albuterol. There is often a history of several days of upper respiratory symptoms, such
as rhinorrhea, mild cough, and mild fever. Rapid antigen tests, blood work, and
radiographs are not usually needed. Radiographs may demonstrate hyperinflation and
atelectasis, but do not show any focal infiltrates like with pneumonia. Bronchiolitis is
usually self-limited, with respiratory status typically improving over 2-5 days.
Management involves supportive care.
Bronchiolitis
What months of the year contain the peak incidence of RSV in North America?
November to March.
A 76-year-old man presents to the emergency department with shortness of
breath and lightheadedness. Vital signs include blood pressure 70/56 mm Hg,
heart rate 124 beats/minute, respiratory rate 22 breaths/minute, and temperature
37.6°C. He has distended neck veins and occasional dropped radial beats. His
lungs are clear to auscultation, but his heart sounds are distant. He has some
fullness to palpation of the right upper quadrant of his abdomen. Which of the
following is the most appropriate diagnostic test?
Bedside echocardiography
, Chest radiograph
Computed tomography angiogram of the chest
Electrocardiogram
Correct Answer ( A )
Explanation:
This patient presents with a clinical picture consistent with obstructive shock. His
distended neck veins, full right upper quadrant, muffled heart sounds, and hypotension
are all consistent with pericardial tamponade. A pericardial sac slowly accumulating fluid
can stretch without obstructing cardiac function. Tamponade occurs when rapid fluid
accumulation results in elevated pressures that inhibit venous return. This is a dynamic
process over the course of the cardiac cycle, therefore bedside echocardiography is the
diagnostic test of choice. Fluid around the heart with evidence of right atrial
compression and right ventricular diastolic collapse are diagnostic of pericardial
tamponade.
Pericardial Effusion
What is the emergent treatment of pericardial tamponade?
Pericardiocentesis.
An 8-year-old African-American girl with a history of sickle cell anemia presents
with diffuse pain consistent with an acute sickle cell pain crisis. While in the
emergency department, she develops acute onset headache, right sided facial
droop and right arm weakness. A CT scan confirms the diagnosis. Which of the
following is the next best step in management?
Alteplase
Exchange transfusion
MRI brain
Tranexamic acid
Correct Answer ( B )
Explanation:
Cerebrovascular events are a potential complication of sickle cell disease. This patient
developed symptoms concerning for acute ischemic stroke. For pediatric patients with
acute ischemic stroke in the setting of sickle cell disease, exchange transfusion is the
treatment of choice. Transfusion goals include decreasing hemoglobin S levels to less
than 30% and obtaining a total hemoglobin level of 10 g/dL. For adults with acute
ischemic stroke in the setting of sickle cell disease, consider tissue plasminogen
activator (tPA). tPA is not indicated or approved for use in pediatric patients
Tranexamic acid (D) is an antifibrinolytic agent used in the management of hemorrhage.
Indications include acute traumatic hemorrhage, intraoperative blood loss, and obstetric
hemorrhage. Tranexamic acid is not used for ischemic events
Manage Sickle Cell
What is the most common bacterial cause of acute chest syndrome in adults with
sickle cell disease?
Atypical bacteria such as Chlamydia pneumoniae, Mycoplasma pneumoniae,
Mycoplasma hominis.
