ROSH REVIEW EMERGENCY MEDICINE
CERTIFICATION SCRIPT 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◍ how does a dystonic reaction present?.
Answer: Dystonic reactions are characterized by involuntary contractions of
muscles of the extremities, face, neck, or pelvis that lead to abnormal
movements or postures
◍ Management of a pilonidal abscess?.
Answer: I&D with outpatient surgery follow-upAbx only if there is
surrounding cellulitis
◍ How long must a manic episode last for the diagnosis of bipolar disorder?.
Answer: at least one week of profound mood disturbance
◍ If a patient with sickle cell disease presents with severe anemia with a
decreased reticulocyte count, how do we treat?.
Answer: transfused with packed red blood cells
◍ What is the treatment for Polycythemia Vera? (2).
Answer: 1. low-dose ASA2. correction of decreased plasma volume with
PHLEBOTOMY - to a Hct of 45%
◍ treatment of cardiogenic shock?.
Answer: inotropic support (dobutamine or milrinone) and norepinephrine
◍ What are S&S of Myasthenia Gravis? (2).
Answer: 1. ocular or generalized muscle weakness2. ptosis and diplopia that
is worse at the end of the day or following exertion
◍ What are the causes of Steven Johnson Syndrome? (2).
Answer: 1. drugs = PEC SLAPP- PCN, ethosuximide, carbamazepine, sulfa,
, lamotrigine, allopurinol, phenytoin, and phenobarbital2. mycoplasma
pneumoniae infections
◍ For most patients with pulmonary embolism who are hemodynamically
stable, how do we treat?.
Answer: DOAC (apixaban or rivaroxaban)
◍ How do you interpret the product of Parkland Formula?.
Answer: the number is the total amount of LRs in mL that should be given
in the first 24 hourshalf should be given in the first 8 hours, then the other
half over the next 16 hours
◍ What is an example of a hallmark sign of Central Vertigo?.
Answer: falling when walking
◍ how do we treat dystonic rxns?.
Answer: diphenhydramine or benzotropine
◍ What is Wernicke Encephalopathy commonly caused by? (3).
Answer: 1. chronic heavy ETOH use2. anorexia nervosa 3. hyperemesis
during pregnancy
◍ What is the treatment for Reye Syndrome?.
Answer: supportive
◍ What are EKG findings for a PE? (3).
Answer: S1Q3T3:1. S wave in lead I2. Q wave in lead III3. flipped T wave
in lead III
◍ What is the treatment for Balantitis?.
Answer: topical antifungal (Clotrimazole)
◍ What is the typical diagnosis and treatment for Aortic Dissections? (2).
Answer: 1. diagnosis = CTA of the aorta 2. treatment = aggressive BP
control with a BB such as Esmolol
◍ how does ischemic colitis present?.
Answer: rapid onset of abdominal pain (LLQ), bloody diarrhea
,◍ the half-life of methadone is longer than __________.
Answer: naloxone, so patients can required multiple doses of naloxone
◍ What are the 3 types of DEFINITIVE Airways? (3).
Answer: 1. OROtracheal tube 2. NASOtracheal tube 3. surgical airway -
cricothyrotomy/tracheostomy
◍ Treatment for both STEMI includes establishing intravenous access,
providing chewable aspirin if no contraindications exist, obtaining a 12-lead
ECG, and ?.
Answer: arranging coronary reperfusion therapy with fibrinolysis (as
indicated) and percutaneous coronary intervention (PCI) in the form of
coronary angioplasty with or without stent placement
◍ What is the treatment for Benzodiazepine Toxicity?.
Answer: 1. supportive- can consider Flumazenil if severe symptoms
◍ What is a common and most consistent finding for Cauda Equina
Syndrome?.
Answer: urinary retention
◍ What is the best treatment for Otitis Externa?.
Answer: otic ciprofloxacin with hydrocortisone
◍ What is the difference between SJS and TEN? (2).
Answer: 1. SJS = more common but only <10% TBSA involvement2. TEN
= >30% TBSA involvement
◍ An acute attack of glaucoma is usually precipitated by?.
Answer: pupillary dilation
◍ tx of acute mesenteric ischemia?.
Answer: anticoagulation, multispeciality care
◍ MOA of triptans?.
Answer: serotonin agonists
◍ what meds are usually the cause of dystonic reactions?.
Answer: first-gen antipsychoticsanti-emetic meds
, ◍ What is the treatment for Myasthenia Gravis?.
Answer: PYRIDOSTIGMINE (acetylcholinesterase inhibitor)
◍ Which nerve is at risk of being injured with a fibular head fracture?.
Answer: PERONEAL nerve
◍ How do you diagnose Polycythemia Vera? (3).
Answer: 1. low EPO level = useful blood test 2. dx made via biopsy OR3.
genetic testing for JAK2 gene mutation
◍ how do we treat mallet finger?.
Answer: Uncomplicated mallet finger injuries are treated by splinting the
distal interphalangeal joint in full extension without flexion at any time for a
period of six to eight weeks
◍ What is the primary treatment intervention for a patient with sickle cell
anemia who presents to the emergency department with an acute ischemic
stroke?.
Answer: Transfusion therapy
◍ How do we treat Wolff-Parkinson white syndrome?.
Answer: For acute, unstable patients: cardioversionFor acute, stable: can
cardiovert with ibutilide or procainamidedefinitive: catheter ablation
◍ MCC of Steven Johnson syndrome after drugs?.
Answer: Mycoplasma pneumonia
◍ What is the most common US finding for Ovarian Torsion?.
Answer: ovarian enlargement due to venous and lymphatic engorgement
◍ How does subacute thyroiditis present?.
Answer: § Labs: Often initially presents as hyperthyroidism (when gland
swells up sometime this happens), decreased TSH + increased free T4
◍ The most common cause of aplastic crisis is infection, and _____________
is the most frequently implicated.
Answer: human parvovirus B19
CERTIFICATION SCRIPT 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◍ how does a dystonic reaction present?.
Answer: Dystonic reactions are characterized by involuntary contractions of
muscles of the extremities, face, neck, or pelvis that lead to abnormal
movements or postures
◍ Management of a pilonidal abscess?.
Answer: I&D with outpatient surgery follow-upAbx only if there is
surrounding cellulitis
◍ How long must a manic episode last for the diagnosis of bipolar disorder?.
Answer: at least one week of profound mood disturbance
◍ If a patient with sickle cell disease presents with severe anemia with a
decreased reticulocyte count, how do we treat?.
Answer: transfused with packed red blood cells
◍ What is the treatment for Polycythemia Vera? (2).
Answer: 1. low-dose ASA2. correction of decreased plasma volume with
PHLEBOTOMY - to a Hct of 45%
◍ treatment of cardiogenic shock?.
Answer: inotropic support (dobutamine or milrinone) and norepinephrine
◍ What are S&S of Myasthenia Gravis? (2).
Answer: 1. ocular or generalized muscle weakness2. ptosis and diplopia that
is worse at the end of the day or following exertion
◍ What are the causes of Steven Johnson Syndrome? (2).
Answer: 1. drugs = PEC SLAPP- PCN, ethosuximide, carbamazepine, sulfa,
, lamotrigine, allopurinol, phenytoin, and phenobarbital2. mycoplasma
pneumoniae infections
◍ For most patients with pulmonary embolism who are hemodynamically
stable, how do we treat?.
Answer: DOAC (apixaban or rivaroxaban)
◍ How do you interpret the product of Parkland Formula?.
Answer: the number is the total amount of LRs in mL that should be given
in the first 24 hourshalf should be given in the first 8 hours, then the other
half over the next 16 hours
◍ What is an example of a hallmark sign of Central Vertigo?.
Answer: falling when walking
◍ how do we treat dystonic rxns?.
Answer: diphenhydramine or benzotropine
◍ What is Wernicke Encephalopathy commonly caused by? (3).
Answer: 1. chronic heavy ETOH use2. anorexia nervosa 3. hyperemesis
during pregnancy
◍ What is the treatment for Reye Syndrome?.
Answer: supportive
◍ What are EKG findings for a PE? (3).
Answer: S1Q3T3:1. S wave in lead I2. Q wave in lead III3. flipped T wave
in lead III
◍ What is the treatment for Balantitis?.
Answer: topical antifungal (Clotrimazole)
◍ What is the typical diagnosis and treatment for Aortic Dissections? (2).
Answer: 1. diagnosis = CTA of the aorta 2. treatment = aggressive BP
control with a BB such as Esmolol
◍ how does ischemic colitis present?.
Answer: rapid onset of abdominal pain (LLQ), bloody diarrhea
,◍ the half-life of methadone is longer than __________.
Answer: naloxone, so patients can required multiple doses of naloxone
◍ What are the 3 types of DEFINITIVE Airways? (3).
Answer: 1. OROtracheal tube 2. NASOtracheal tube 3. surgical airway -
cricothyrotomy/tracheostomy
◍ Treatment for both STEMI includes establishing intravenous access,
providing chewable aspirin if no contraindications exist, obtaining a 12-lead
ECG, and ?.
Answer: arranging coronary reperfusion therapy with fibrinolysis (as
indicated) and percutaneous coronary intervention (PCI) in the form of
coronary angioplasty with or without stent placement
◍ What is the treatment for Benzodiazepine Toxicity?.
Answer: 1. supportive- can consider Flumazenil if severe symptoms
◍ What is a common and most consistent finding for Cauda Equina
Syndrome?.
Answer: urinary retention
◍ What is the best treatment for Otitis Externa?.
Answer: otic ciprofloxacin with hydrocortisone
◍ What is the difference between SJS and TEN? (2).
Answer: 1. SJS = more common but only <10% TBSA involvement2. TEN
= >30% TBSA involvement
◍ An acute attack of glaucoma is usually precipitated by?.
Answer: pupillary dilation
◍ tx of acute mesenteric ischemia?.
Answer: anticoagulation, multispeciality care
◍ MOA of triptans?.
Answer: serotonin agonists
◍ what meds are usually the cause of dystonic reactions?.
Answer: first-gen antipsychoticsanti-emetic meds
, ◍ What is the treatment for Myasthenia Gravis?.
Answer: PYRIDOSTIGMINE (acetylcholinesterase inhibitor)
◍ Which nerve is at risk of being injured with a fibular head fracture?.
Answer: PERONEAL nerve
◍ How do you diagnose Polycythemia Vera? (3).
Answer: 1. low EPO level = useful blood test 2. dx made via biopsy OR3.
genetic testing for JAK2 gene mutation
◍ how do we treat mallet finger?.
Answer: Uncomplicated mallet finger injuries are treated by splinting the
distal interphalangeal joint in full extension without flexion at any time for a
period of six to eight weeks
◍ What is the primary treatment intervention for a patient with sickle cell
anemia who presents to the emergency department with an acute ischemic
stroke?.
Answer: Transfusion therapy
◍ How do we treat Wolff-Parkinson white syndrome?.
Answer: For acute, unstable patients: cardioversionFor acute, stable: can
cardiovert with ibutilide or procainamidedefinitive: catheter ablation
◍ MCC of Steven Johnson syndrome after drugs?.
Answer: Mycoplasma pneumonia
◍ What is the most common US finding for Ovarian Torsion?.
Answer: ovarian enlargement due to venous and lymphatic engorgement
◍ How does subacute thyroiditis present?.
Answer: § Labs: Often initially presents as hyperthyroidism (when gland
swells up sometime this happens), decreased TSH + increased free T4
◍ The most common cause of aplastic crisis is infection, and _____________
is the most frequently implicated.
Answer: human parvovirus B19
