EMERGENCY MEDICINE (COMAT) EXPECTED
QUESTIONS WITH VERIFIED ANSWERS
Question 1.
TIMI score
ANSWER
a prognostic tool for patients with unstabe angina or NSTEMI Categorizes patient's risk of death and
ischemic events & helps clinicians with therapeutic decision-making. A point of one for each of the
following:
1) apsirin use in the last seven days
2) ST changes of at least 0.5 mm on EKG
3) Elevated serum cardiac biomarkers
4) Age greater than 65
5) known CAD (coronary stenosis greater than or equal to equal to 50%)
6) At least two angina episodes within the last 24 hours
7) At least three risk factors for CAD such as: HTN, DM, current cigarette smoker,
family hx of premature CAD (CAD in male first-degree relative or father less than 55, or female
first-degree relative or mother less than 65)
Question 2.
most common complication associated with giving pediatric patients succinylcholine
ANSWER
Rhabdomyolysis with associated hyperkalemia Tx - copious IV Fluid hydration
Question 3.
Contraindications to succinylcholine
ANSWER
burns, crush injuries, renal failure, immobilization for >48 hours, narrow angle glaucoma & malignant
hyperthermia.
Question 4.
hyperkalemia a huge concern?
ANSWER
Severe burns, crush injuries, & renal failure.
1
,Question 5.
Glasgow Coma Scale
ANSWER
Question 6.
What to do with a patient with a GCS of 8?
ANSWER
Intubation
Question 7.
Thoracic injuries secondary to blunt chest
ANSWER
The plain CXR remains the standard initial diagnostic remains the standard initial diagnostic study for
the evaluation of chest trauma in a hemodynamically stable patient. CXR in blunt trauma patients are
usually taken in the supine position initially until unstable spinal fractures have been ruled out. Then,
it is important to get a PA view to appropriately evaluate for small hemothorax, pneumothorax o
diaphragm injury.
Question 8.
What is first line in supraventricular tachycardia?
ANSWER
Vagal maneuvers
2
, Question 9.
Compartment syndrome
ANSWER
Associated with five P's - pain, paraesthesia, pallor, pulselessness, & poikilothermia Critical level =
Btwn 10 mmHg & 35 mmHg Poor outcomes = >30 mmHg Fasciotomy is the definitive treatment
Question 10.
Normal compartment pressure
ANSWER
<10 mmHg
Question 11.
Interstitial cystitis
ANSWER
also known as bladder pain syndrome Is a chronic condition diagnosed in patients with symptoms of
dysuria, frequency, urgency with no other causes of such symptoms.
Question 12.
Tx'ment of DKA (steps)
ANSWER
1) Volume expansion with IVF (0.45% NACl or 0.9% NaCl at 250-500 ml/hour)
--Bolus anywhere from 2-4 liters of fluid prior to starting IV insulin
2) Check potassium levels is checked and replace as needed
3) An insulin drip will need to be started at 0.1 unit/kg/hour
--after serum glucose
4) Check serum pH level to determine if bicarbonate is needed in the fluids
5) When serum glucose is at a reasonable level 200 mg/dL), the fluids should be
changed to D5 0.45% NaCl & the insulin drip is weaned.
Question 13.
Influenza Treatment
ANSWER
Immunoprophylaxis - inactivated vaccine ---Trivalent vaccine - prepared on annual basis with two
strains of influenza A & one strain of influenza B---- Chemoprophylaxis - influenza-specific antiviral
agents
1) Anantadine
2) Rimantadine
3) Zanamivir
4) Oseltamivir
5) Peramivir
3
QUESTIONS WITH VERIFIED ANSWERS
Question 1.
TIMI score
ANSWER
a prognostic tool for patients with unstabe angina or NSTEMI Categorizes patient's risk of death and
ischemic events & helps clinicians with therapeutic decision-making. A point of one for each of the
following:
1) apsirin use in the last seven days
2) ST changes of at least 0.5 mm on EKG
3) Elevated serum cardiac biomarkers
4) Age greater than 65
5) known CAD (coronary stenosis greater than or equal to equal to 50%)
6) At least two angina episodes within the last 24 hours
7) At least three risk factors for CAD such as: HTN, DM, current cigarette smoker,
family hx of premature CAD (CAD in male first-degree relative or father less than 55, or female
first-degree relative or mother less than 65)
Question 2.
most common complication associated with giving pediatric patients succinylcholine
ANSWER
Rhabdomyolysis with associated hyperkalemia Tx - copious IV Fluid hydration
Question 3.
Contraindications to succinylcholine
ANSWER
burns, crush injuries, renal failure, immobilization for >48 hours, narrow angle glaucoma & malignant
hyperthermia.
Question 4.
hyperkalemia a huge concern?
ANSWER
Severe burns, crush injuries, & renal failure.
1
,Question 5.
Glasgow Coma Scale
ANSWER
Question 6.
What to do with a patient with a GCS of 8?
ANSWER
Intubation
Question 7.
Thoracic injuries secondary to blunt chest
ANSWER
The plain CXR remains the standard initial diagnostic remains the standard initial diagnostic study for
the evaluation of chest trauma in a hemodynamically stable patient. CXR in blunt trauma patients are
usually taken in the supine position initially until unstable spinal fractures have been ruled out. Then,
it is important to get a PA view to appropriately evaluate for small hemothorax, pneumothorax o
diaphragm injury.
Question 8.
What is first line in supraventricular tachycardia?
ANSWER
Vagal maneuvers
2
, Question 9.
Compartment syndrome
ANSWER
Associated with five P's - pain, paraesthesia, pallor, pulselessness, & poikilothermia Critical level =
Btwn 10 mmHg & 35 mmHg Poor outcomes = >30 mmHg Fasciotomy is the definitive treatment
Question 10.
Normal compartment pressure
ANSWER
<10 mmHg
Question 11.
Interstitial cystitis
ANSWER
also known as bladder pain syndrome Is a chronic condition diagnosed in patients with symptoms of
dysuria, frequency, urgency with no other causes of such symptoms.
Question 12.
Tx'ment of DKA (steps)
ANSWER
1) Volume expansion with IVF (0.45% NACl or 0.9% NaCl at 250-500 ml/hour)
--Bolus anywhere from 2-4 liters of fluid prior to starting IV insulin
2) Check potassium levels is checked and replace as needed
3) An insulin drip will need to be started at 0.1 unit/kg/hour
--after serum glucose
4) Check serum pH level to determine if bicarbonate is needed in the fluids
5) When serum glucose is at a reasonable level 200 mg/dL), the fluids should be
changed to D5 0.45% NaCl & the insulin drip is weaned.
Question 13.
Influenza Treatment
ANSWER
Immunoprophylaxis - inactivated vaccine ---Trivalent vaccine - prepared on annual basis with two
strains of influenza A & one strain of influenza B---- Chemoprophylaxis - influenza-specific antiviral
agents
1) Anantadine
2) Rimantadine
3) Zanamivir
4) Oseltamivir
5) Peramivir
3
