EMERGENCY MEDICINE EOR EXAM LATEST 2024-
2025 ACTUAL EXAM 250 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |
ALREADY GRADED A+
A 35-year-old woman with a history of migraines and polycystic kidney disease presents to the
Emergency Department with a severe, diffuse headache. The onset was abrupt approximately one hour
prior to arrival. Her vital signs are within normal limits. She has photophobia and phonophobia, as well
as pain with extraocular movements. Which of the following is the most likely diagnosis?
Subarachnoid hemorrhage
A 55-year-old woman presents with right finger pain. She reports she habitually bites her nails. On
examination, the lateral nail fold and cuticle of the right ring finger is erythematous, fluctuant and tender
to palpation. Which of the following is the most likely diagnosis?
Paronychia
A 25-year-old man is brought to the emergency department by police for bizarre behavior. His family
arrives and states that his behavior changed about eight months ago. He does not abuse drugs or
alcohol. On examination, he has a flat affect and appears to be responding to internal stimuli. His speech
is disorganized and he says, "I've been running from the Russians who are trying to steal my thoughts."
His laboratory and urine studies are unremarkable. What is the most likely diagnosis? Schizophrenia
A 44-year-old woman presents to the emergency department with one week of crampy abdominal pain
that is worse after she eats. She denies alcohol consumption or tobacco abuse. On physical examination,
she is overweight and has epigastric and right upper quadrant abdominal tenderness to palpation. Which
of the following examination findings is most consistent with cholecystitis? Inspiratory arrest with right
upper quadrant palpation
A 50-year-old woman presents to the emergency department following a syncopal episode. On physical
exam she is diaphoretic. She is alert and oriented. Her blood pressure is 90/50 mm Hg and respirations
are 12 per minute. Her rhythm strip is shown above. What is the most appropriate pharmacologic
treatment for this patient's condition?
Atropine
A 14-year-old boy presents complaining of intense pruritus in his groin, axillae, and between his fingers
after returning home from 4-week summer camp one 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? Permethrin
,Which of the following is the most sensitive finding in cauda equina syndrome? Urinary
retention
A 77-year-old woman presents to the ED with acute painless vision loss. On funduscopic exam, you note
the above. Which of the following is the most likely diagnosis?
Central retinal artery occlusion
A 56-year-old woman with a history of hypertension, diabetes mellitus, and hypercholesterolemia
presents with acute substernal chest pain that is worse with exertion and associated with nausea and
shortness of breath. Her sister and her mother both had "heart attacks" before age 55 years. Which of
the following offers a proven mortality benefit in acute coronary syndrome? Aspirin
A 75-year-old man with a long-standing history of constipation presents complaining of abdominal pain
for the last two days. He is now experiencing abdominal distention, constipation, and inability to pass
gas for the last 12 hours. On examination, his abdomen is distended and tympanitic to percussion. You
obtain an upright abdominal X-ray as seen above. What is the most likely diagnosis? Sigmoid volvulus
A 65-year-old man presents to the ED with diffuse bone pain, abdominal cramping, and severe
constipation. He is currently undergoing dialysis for end-stage renal disease but has not been to dialysis
this week. Physical exam reveals a lethargic man with diffuse abdominal tenderness without rebound or
guarding. Which of the following is the most likely etiology for his symptoms? Hypercalcemia
Which of the following is the most common injury seen in a child with severe blunt chest trauma such as
being struck by a motor vehicle?
Pulmonary contusion
A 79-year-old man presents to the ED complaining of dyspnea. His rhythm strip is shown above. What is
the most likely underlying process?
Chronic obstructive pulmonary disease
Which of the following is one of the most helpful signs to rule out testicular torsion? Presence
of the cremasteric reflex
, A 72-year-old man presents to the emergency department with left eye pain. Earlier this evening he was
involved in a fistfight. He reports getting punched in the eye with no loss of consciousness. He now has
eye pain and blurry vision. On physical exam his visual acuity is 20/50 in the left eye and 20/20 in the
right eye. His intraocular pressure is 14 on the left. His left eye is shown above. What is the most likely
diagnosis?
Hyphema
A 42-year-old man with a history of alcohol abuse presents with severe abdominal pain and vomiting
following an alcohol binge. Lab values are as follows: WBC 14,000, Hgb 10, platelets 98, lipase 9000, AST
200, ALT 107, T. bill 1.6, Na 134, K 5.1, Cr. 3.1, and glucose 313. Which of the following lab values is
associated with increased mortality?
Glucose of 313
A 38-year-old man presents to the emergency department with low back pain that began this morning
when he rolled over in bed. Throughout the day, he tried ibuprofen and acetaminophen without relief,
which prompted him to come to the Emergency Department for further evaluation. Which of the
following historical findings is an indication for further investigation?
Fever
An 18-month-old boy presents with his father for a cough and difficulty breathing. The father states that
the child has had nasal congestion and coryza for the last two days. On exam, he has a barking cough,
inspiratory stridor, and a prolonged inspiratory phase. Which of the following would you expect to see on
radiographic evaluation?
Subglottic narrowing
A 42-year-old man presents to the ED with racing heart rate and difficulty breathing. On physical exam,
you note bilateral ocular proptosis and 3+ non-pitting edema of the bilateral lower extremities. His
electrocardiogram is shown above. Which of the following complications of this disease is this patient
most likely experiencing?
High output heart failure
A 55-year-old man presents with fever and right upper quadrant pain. On examination, you note that the
patient is jaundiced and slightly altered. Clinically you make the diagnosis of cholangitis. Which of the
following is the final component of Reynold's pentad?
Hypotension
A 58-year-old man presents with chest pain. His electrocardiogram is shown above. A right-sided
electrocardiogram is also performed and shows elevated ST segments in V4R and V5R. Which of the
following medications is contraindicated?
Nitroglycerin
A 44-year-old man with systemic lupus erythematosus presents to the ED with chest pain and dyspnea.
Vital signs are notable for tachycardia and hypotension with a narrow pulse pressure. Bedside ultrasound
2025 ACTUAL EXAM 250 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |
ALREADY GRADED A+
A 35-year-old woman with a history of migraines and polycystic kidney disease presents to the
Emergency Department with a severe, diffuse headache. The onset was abrupt approximately one hour
prior to arrival. Her vital signs are within normal limits. She has photophobia and phonophobia, as well
as pain with extraocular movements. Which of the following is the most likely diagnosis?
Subarachnoid hemorrhage
A 55-year-old woman presents with right finger pain. She reports she habitually bites her nails. On
examination, the lateral nail fold and cuticle of the right ring finger is erythematous, fluctuant and tender
to palpation. Which of the following is the most likely diagnosis?
Paronychia
A 25-year-old man is brought to the emergency department by police for bizarre behavior. His family
arrives and states that his behavior changed about eight months ago. He does not abuse drugs or
alcohol. On examination, he has a flat affect and appears to be responding to internal stimuli. His speech
is disorganized and he says, "I've been running from the Russians who are trying to steal my thoughts."
His laboratory and urine studies are unremarkable. What is the most likely diagnosis? Schizophrenia
A 44-year-old woman presents to the emergency department with one week of crampy abdominal pain
that is worse after she eats. She denies alcohol consumption or tobacco abuse. On physical examination,
she is overweight and has epigastric and right upper quadrant abdominal tenderness to palpation. Which
of the following examination findings is most consistent with cholecystitis? Inspiratory arrest with right
upper quadrant palpation
A 50-year-old woman presents to the emergency department following a syncopal episode. On physical
exam she is diaphoretic. She is alert and oriented. Her blood pressure is 90/50 mm Hg and respirations
are 12 per minute. Her rhythm strip is shown above. What is the most appropriate pharmacologic
treatment for this patient's condition?
Atropine
A 14-year-old boy presents complaining of intense pruritus in his groin, axillae, and between his fingers
after returning home from 4-week summer camp one 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? Permethrin
,Which of the following is the most sensitive finding in cauda equina syndrome? Urinary
retention
A 77-year-old woman presents to the ED with acute painless vision loss. On funduscopic exam, you note
the above. Which of the following is the most likely diagnosis?
Central retinal artery occlusion
A 56-year-old woman with a history of hypertension, diabetes mellitus, and hypercholesterolemia
presents with acute substernal chest pain that is worse with exertion and associated with nausea and
shortness of breath. Her sister and her mother both had "heart attacks" before age 55 years. Which of
the following offers a proven mortality benefit in acute coronary syndrome? Aspirin
A 75-year-old man with a long-standing history of constipation presents complaining of abdominal pain
for the last two days. He is now experiencing abdominal distention, constipation, and inability to pass
gas for the last 12 hours. On examination, his abdomen is distended and tympanitic to percussion. You
obtain an upright abdominal X-ray as seen above. What is the most likely diagnosis? Sigmoid volvulus
A 65-year-old man presents to the ED with diffuse bone pain, abdominal cramping, and severe
constipation. He is currently undergoing dialysis for end-stage renal disease but has not been to dialysis
this week. Physical exam reveals a lethargic man with diffuse abdominal tenderness without rebound or
guarding. Which of the following is the most likely etiology for his symptoms? Hypercalcemia
Which of the following is the most common injury seen in a child with severe blunt chest trauma such as
being struck by a motor vehicle?
Pulmonary contusion
A 79-year-old man presents to the ED complaining of dyspnea. His rhythm strip is shown above. What is
the most likely underlying process?
Chronic obstructive pulmonary disease
Which of the following is one of the most helpful signs to rule out testicular torsion? Presence
of the cremasteric reflex
, A 72-year-old man presents to the emergency department with left eye pain. Earlier this evening he was
involved in a fistfight. He reports getting punched in the eye with no loss of consciousness. He now has
eye pain and blurry vision. On physical exam his visual acuity is 20/50 in the left eye and 20/20 in the
right eye. His intraocular pressure is 14 on the left. His left eye is shown above. What is the most likely
diagnosis?
Hyphema
A 42-year-old man with a history of alcohol abuse presents with severe abdominal pain and vomiting
following an alcohol binge. Lab values are as follows: WBC 14,000, Hgb 10, platelets 98, lipase 9000, AST
200, ALT 107, T. bill 1.6, Na 134, K 5.1, Cr. 3.1, and glucose 313. Which of the following lab values is
associated with increased mortality?
Glucose of 313
A 38-year-old man presents to the emergency department with low back pain that began this morning
when he rolled over in bed. Throughout the day, he tried ibuprofen and acetaminophen without relief,
which prompted him to come to the Emergency Department for further evaluation. Which of the
following historical findings is an indication for further investigation?
Fever
An 18-month-old boy presents with his father for a cough and difficulty breathing. The father states that
the child has had nasal congestion and coryza for the last two days. On exam, he has a barking cough,
inspiratory stridor, and a prolonged inspiratory phase. Which of the following would you expect to see on
radiographic evaluation?
Subglottic narrowing
A 42-year-old man presents to the ED with racing heart rate and difficulty breathing. On physical exam,
you note bilateral ocular proptosis and 3+ non-pitting edema of the bilateral lower extremities. His
electrocardiogram is shown above. Which of the following complications of this disease is this patient
most likely experiencing?
High output heart failure
A 55-year-old man presents with fever and right upper quadrant pain. On examination, you note that the
patient is jaundiced and slightly altered. Clinically you make the diagnosis of cholangitis. Which of the
following is the final component of Reynold's pentad?
Hypotension
A 58-year-old man presents with chest pain. His electrocardiogram is shown above. A right-sided
electrocardiogram is also performed and shows elevated ST segments in V4R and V5R. Which of the
following medications is contraindicated?
Nitroglycerin
A 44-year-old man with systemic lupus erythematosus presents to the ED with chest pain and dyspnea.
Vital signs are notable for tachycardia and hypotension with a narrow pulse pressure. Bedside ultrasound
