GUARANTEED PASS: EMERGENCY MEDICINE END OF
ROTATION EXAM 2025-2026 QUESTIONS AND ANSWERS
GRADED A+
1.What is the immediate management mnemonic for ADHF?
LMNOP: Lasix, Morphine (less common now), Nitrates, Oxygen (CPAP), Position
2.What defines HFrEF (Systolic HF)?
Heart failure with an Ejection Fraction ≤40%
3.What are the four foundational "pillar" meds for HFrEF?
ARNI (or ACE/ARB), Beta-blocker, Mineralocorticoid Receptor Antagonist (MRA), and
SGLT2 inhibitor
4.What is the most common cause of HFpEF (Diastolic HF)?
Chronic Hypertension leading to Left Ventricular Hypertrophy
5.What is the classic triad of Acute Decompensated Heart Failure (ADHF) on CXR?
Cephalization of flow, Kerley B lines, and Cardiomegaly
6.What is the treatment for Vasospastic (Prinzmetal) Angina?
Calcium Channel Blockers and Nitrates (Avoid Beta-blockers)
7.What is the BP threshold for diagnosing Chronic Hypertension?
≥130/80 mmHg on at least two separate occasions
8.What differentiates Hypertensive Emergency from Urgency?
Emergency involves evidence of acute end-organ damage (e.g., encephalopathy, ACS, AKI)
9.What is the BP reduction goal in Hypertensive Emergency?
Reduce MAP by no more than 25% in the first hour to prevent cerebral ischemia
, 10.What is the hemodynamic profile of Hypovolemic Shock?
Low PCWP, Low CO, High SVR
11.What defines Orthostatic Hypotension?
Drop in SBP >20 mmHg or DBP >10 mmHg within 3 minutes of standing
12.What is the most common cause of Vasovagal Syncope?
Enhanced vagal tone leading to transient bradycardia and vasodilation (often triggered by
stress/pain)
13.What is the hallmark of all types of Shock?
Inadequate tissue perfusion (hypoperfusion)
14.What is the hemodynamic profile of Cardiogenic Shock?
High PCWP (Preload), Low CO, High SVR (Afterload)
15. What is the first-line IV drug for Hypertensive Emergency with Aortic Dissection?
Esmolol (Beta-blocker) to reduce shear stress
16.What is the only type of shock where SVR is decreased?
Distributive Shock (Sepsis, Anaphylaxis, Neurogenic)
17.What is the first-line vasopressor for Septic Shock?
Norepinephrine (Levophed)
18.What is the treatment for Obstructive Shock due to Tension Pneumothorax?
Needle decompression followed by chest tube
19.What is the classic physical exam finding in Acute Rheumatic Carditis?
New onset murmur (usually Mitral Regurgitation) and friction rub
ROTATION EXAM 2025-2026 QUESTIONS AND ANSWERS
GRADED A+
1.What is the immediate management mnemonic for ADHF?
LMNOP: Lasix, Morphine (less common now), Nitrates, Oxygen (CPAP), Position
2.What defines HFrEF (Systolic HF)?
Heart failure with an Ejection Fraction ≤40%
3.What are the four foundational "pillar" meds for HFrEF?
ARNI (or ACE/ARB), Beta-blocker, Mineralocorticoid Receptor Antagonist (MRA), and
SGLT2 inhibitor
4.What is the most common cause of HFpEF (Diastolic HF)?
Chronic Hypertension leading to Left Ventricular Hypertrophy
5.What is the classic triad of Acute Decompensated Heart Failure (ADHF) on CXR?
Cephalization of flow, Kerley B lines, and Cardiomegaly
6.What is the treatment for Vasospastic (Prinzmetal) Angina?
Calcium Channel Blockers and Nitrates (Avoid Beta-blockers)
7.What is the BP threshold for diagnosing Chronic Hypertension?
≥130/80 mmHg on at least two separate occasions
8.What differentiates Hypertensive Emergency from Urgency?
Emergency involves evidence of acute end-organ damage (e.g., encephalopathy, ACS, AKI)
9.What is the BP reduction goal in Hypertensive Emergency?
Reduce MAP by no more than 25% in the first hour to prevent cerebral ischemia
, 10.What is the hemodynamic profile of Hypovolemic Shock?
Low PCWP, Low CO, High SVR
11.What defines Orthostatic Hypotension?
Drop in SBP >20 mmHg or DBP >10 mmHg within 3 minutes of standing
12.What is the most common cause of Vasovagal Syncope?
Enhanced vagal tone leading to transient bradycardia and vasodilation (often triggered by
stress/pain)
13.What is the hallmark of all types of Shock?
Inadequate tissue perfusion (hypoperfusion)
14.What is the hemodynamic profile of Cardiogenic Shock?
High PCWP (Preload), Low CO, High SVR (Afterload)
15. What is the first-line IV drug for Hypertensive Emergency with Aortic Dissection?
Esmolol (Beta-blocker) to reduce shear stress
16.What is the only type of shock where SVR is decreased?
Distributive Shock (Sepsis, Anaphylaxis, Neurogenic)
17.What is the first-line vasopressor for Septic Shock?
Norepinephrine (Levophed)
18.What is the treatment for Obstructive Shock due to Tension Pneumothorax?
Needle decompression followed by chest tube
19.What is the classic physical exam finding in Acute Rheumatic Carditis?
New onset murmur (usually Mitral Regurgitation) and friction rub
