Foreign Bodies, SAEM AMS, CV, trauma, SAEM MISC, SAEM -
Shock and Sepsis, Environment and Endocrine, Pulm Emergencies ||
All Accurately Answered.
A 5 year old child was eating an almond when he experienced sudden, intermittent bouts of
choking and wheezing. Assuming this child aspirated an almond, which of the following is most
likely to be seen on chest X-ray?
Answers:
1.A. Atelectasis of the affected lung
2.B. Diaphragmatic flattening of the non-affected lung
3.C. Foreign body in the shape of an almond
4.D. Hypoinflation of the non-affected lung correct answers atelectasis of the affected lung
A 22 year old college student arrives in the emergency department complaing of painful, tearing,
and redness in the right eye. Blinking increases the pain. She wears contact lenses for distance
vision but has no other ocular history. During your examination, you evert her upper eyelid. ED
management of this patient includes:
Answers:
1.A. Avoidance of Fluorescein examination due to concern for globe rupture
2.B. Immediate application of pilocarpine drops
3.C. Instructions to wear an eye patch for the next 48 hours
,4.D. Removal of the foreign body with a moistened cotton swab correct answers Removal of
foreign body with cotton swab
You have a 3 year old female present with her mother with compaints of two days of left ear
pain. On exam, you are unable to visualize the tympanic membrane due to an obstructing mass.
You suspect a foreign body. Which of following is TRUE regarding the removing a foreign
object from the patient's ear canal?
Answers:
1.A. Avoid suction as it may lead to a perforation of the tympanic membrane
2.B. Referral to an otolaryngologist for foreign body removal under general anesthesia may be
required in an uncooperative infant
3.C. To remove a live insect from the external ear canal, grasp a leg with hemostats and pull
firmly
4.D. You should avoid the use of lidocaine and other topical anesthetics due to the risk of
localized tissue ischemia correct answers Referral to ENT for removal
Management of a 4 year old child with a two-week history of malodorous purulent nasal
drainage should include, as an initial step:
Answers:
1.A. Oral amoxicillin for 10-14 days
2.B. Referral to an otolaryngologist
,3.C. Social services consultation to investigate potential child abuse
4.D. Speculum examination of the nares correct answers speculum exam of nares
You suspect that your patient has swallowed a nail. Which of the following is an indication for
endoscopic or surgical removal of this object?
Answers:
1.A. Abdominal CT scan shows a 1cm nail in the distal sigmoid colon
2.B. Plain films do not reveal a radiopaque foreign body in the chest or abdomen
3.C. Radiography visualizes the nail in the gastric fundus
4.D. The object has progressed from the jejunum through the ileum after 24 hours correct
answers radiography visualization in gastric fundus
A 54 year old male presents with complaints of a foreign body sensation in his left eye. Which of
the following is an indication of urgen ophthalmologic referral?
Answers:
1.A. You discover a moderate-sized linear corneal abrasion
2.B. You note a small puncture wound in the globe
, 3.C. Your examination reveals a metallic foreign body that is loosely adherent to the white of the
eye
4.D. You note an intraocular pressure of 20 in the affected eye correct answers small puncture in
globe
Recurrent cellulitis in the distal phalanx of the right thumb in a 32 year old carpenter who is
otherwise healthy should prompt the emergency room physicians to perform:
Answers:
1.A. A deep, longitudinal 2-cm incision to explore the thumb for an abscess
2.B. Radiographic imaging for suspected retained foreign body
3.C. Screening for Human Immunodeficiency Virus
4.D. Testing for diabetes mellitus correct answers imaging for suspected retained body
A patient presents to the emergency department with alcohol intoxication (precluding a useful
history) and eye pain. The extrnal eye exam reveals an eliptically misshapen pupil, and a
hyphema is also noted. A slice from a head CT (obtained due to patient's unclear history and
intoxication). Of the following choices, which is the best next step for the emergency physician
evaluating this patient?
Answers:
1.A. palpation of the globe with mild digital pressure, to determine if increased intraocular
pressure is present
Shock and Sepsis, Environment and Endocrine, Pulm Emergencies ||
All Accurately Answered.
A 5 year old child was eating an almond when he experienced sudden, intermittent bouts of
choking and wheezing. Assuming this child aspirated an almond, which of the following is most
likely to be seen on chest X-ray?
Answers:
1.A. Atelectasis of the affected lung
2.B. Diaphragmatic flattening of the non-affected lung
3.C. Foreign body in the shape of an almond
4.D. Hypoinflation of the non-affected lung correct answers atelectasis of the affected lung
A 22 year old college student arrives in the emergency department complaing of painful, tearing,
and redness in the right eye. Blinking increases the pain. She wears contact lenses for distance
vision but has no other ocular history. During your examination, you evert her upper eyelid. ED
management of this patient includes:
Answers:
1.A. Avoidance of Fluorescein examination due to concern for globe rupture
2.B. Immediate application of pilocarpine drops
3.C. Instructions to wear an eye patch for the next 48 hours
,4.D. Removal of the foreign body with a moistened cotton swab correct answers Removal of
foreign body with cotton swab
You have a 3 year old female present with her mother with compaints of two days of left ear
pain. On exam, you are unable to visualize the tympanic membrane due to an obstructing mass.
You suspect a foreign body. Which of following is TRUE regarding the removing a foreign
object from the patient's ear canal?
Answers:
1.A. Avoid suction as it may lead to a perforation of the tympanic membrane
2.B. Referral to an otolaryngologist for foreign body removal under general anesthesia may be
required in an uncooperative infant
3.C. To remove a live insect from the external ear canal, grasp a leg with hemostats and pull
firmly
4.D. You should avoid the use of lidocaine and other topical anesthetics due to the risk of
localized tissue ischemia correct answers Referral to ENT for removal
Management of a 4 year old child with a two-week history of malodorous purulent nasal
drainage should include, as an initial step:
Answers:
1.A. Oral amoxicillin for 10-14 days
2.B. Referral to an otolaryngologist
,3.C. Social services consultation to investigate potential child abuse
4.D. Speculum examination of the nares correct answers speculum exam of nares
You suspect that your patient has swallowed a nail. Which of the following is an indication for
endoscopic or surgical removal of this object?
Answers:
1.A. Abdominal CT scan shows a 1cm nail in the distal sigmoid colon
2.B. Plain films do not reveal a radiopaque foreign body in the chest or abdomen
3.C. Radiography visualizes the nail in the gastric fundus
4.D. The object has progressed from the jejunum through the ileum after 24 hours correct
answers radiography visualization in gastric fundus
A 54 year old male presents with complaints of a foreign body sensation in his left eye. Which of
the following is an indication of urgen ophthalmologic referral?
Answers:
1.A. You discover a moderate-sized linear corneal abrasion
2.B. You note a small puncture wound in the globe
, 3.C. Your examination reveals a metallic foreign body that is loosely adherent to the white of the
eye
4.D. You note an intraocular pressure of 20 in the affected eye correct answers small puncture in
globe
Recurrent cellulitis in the distal phalanx of the right thumb in a 32 year old carpenter who is
otherwise healthy should prompt the emergency room physicians to perform:
Answers:
1.A. A deep, longitudinal 2-cm incision to explore the thumb for an abscess
2.B. Radiographic imaging for suspected retained foreign body
3.C. Screening for Human Immunodeficiency Virus
4.D. Testing for diabetes mellitus correct answers imaging for suspected retained body
A patient presents to the emergency department with alcohol intoxication (precluding a useful
history) and eye pain. The extrnal eye exam reveals an eliptically misshapen pupil, and a
hyphema is also noted. A slice from a head CT (obtained due to patient's unclear history and
intoxication). Of the following choices, which is the best next step for the emergency physician
evaluating this patient?
Answers:
1.A. palpation of the globe with mild digital pressure, to determine if increased intraocular
pressure is present
