Page 1 of 222
McGraw-Hill Emergency medicine Exam Review
(Tintinalli's) EXAM NEWEST VERSION WITH
COMPLETE 600 QUESTIONS AND CORRECT
GUARANTEED ANSWERS JUST RELEASED
A 65-year-old male presents with AMI symptoms after thrombolysis but remains unstable...
The next best course of action would be:
A. Dopamine infusion
B. Nitroglycerin drip
C. Placement of an aortic balloon pump
D. Repeat thrombolytic administration
E. Rescue PCI
Correct answer: E. Rescue PCI
Explanation:
Rescue PCI is indicated when fibrinolysis fails in AMI with persistent pain and hemodynamic
instability.
Which of the following is the BEST answer regarding medication for back pain and sciatica?
A. Cyclobenzaprine (Flexeril) is an appropriate long-term medication for chronic back pain.
B. NSAIDs are an appropriate long-term treatment for chronic low back pain in patients at low
risk of side effects.
C. Opioids are appropriate long-term agents to use for chronic back pain.
D. Steroids are an effective and long-lasting treatment for acute sciatica.
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E. Tricyclic antidepressants are NOT appropriate long-term medications for use in chronic back
pain.
Correct answer: B. NSAIDs are an appropriate long-term treatment for chronic low back
pain in patients at low risk of side effects.
Explanation:
NSAIDs are effective and appropriate if used cautiously, considering gastrointestinal and renal
risks.
Which of the following methods is NOT an appropriate way to decrease the pain of infiltration
from a local anesthetic?
A. Buffering the anesthetic solution with sodium bicarbonate prior to infiltration
B. Injecting through the wound margins instead of through intact skin
C. Rapid injection to minimize the duration of pain
D. Using 1 mL of sodium bicarbonate 8.4% to buffer 29 mL of bupivacaine 0.25%
E. Warming the solution to body temperature before injecting
Correct answer: C. Rapid injection to minimize the duration of pain
Explanation:
Pain can be minimized by slow injection, warming the solution, injecting through wound
margins, and buffering with sodium bicarbonate. Rapid injection increases discomfort.
What is the MOST common cause of cardiogenic shock?
A. Acute aortic insufficiency
B. Aortic stenosis
C. Hypertrophic cardiomyopathy
D. Acute myocardial infarction (AMI)
E. Pericardial tamponade
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Correct answer: D. Acute myocardial infarction (AMI)
Explanation:
Cardiogenic shock most commonly results from extensive myocardial infarction with loss of
contractility.
Which is TRUE about chronic pain?
A. Chronic pain is more common in elderly patients.
B. Less than 25% of patients whose pain lasts 3 months will continue to have chronic pain for
several years.
C. The goal of emergency treatment should be complete relief of pain.
D. The head is the most common location of chronic pain.
E. Patients presenting to the emergency department because of chronic pain are best helped by
hospital admission.
Correct answer: A. Chronic pain is more common in elderly patients.
Explanation:
Chronic pain is more frequent in the elderly, especially in the back. Complete pain relief is
usually unrealistic; referral to a pain clinic is preferred.
What is the significance of a third heart sound (S3) in the diagnosis of CHF?
A. Absence suggests increased 90-day mortality
B. Absence suggests worse outcome
C. Presence suggests an elevated pulmonary capillary wedge pressure
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D. Presence suggests improved outcome
E. Presence rules out CHF
Correct answer: C. Presence suggests an elevated pulmonary capillary wedge pressure
Explanation:
An S3 indicates increased left ventricular filling pressures and supports a diagnosis of congestive
heart failure.
An anxious 50-year-old female drug user with a 10-cm thigh abscess... What type of sedation
is this called?
A. Deep sedation
B. Dissociation
C. General anesthesia
D. Minimal sedation
E. Moderate sedation
Correct answer: D. Minimal sedation
Explanation:
Minimal sedation involves anxiolysis with the patient remaining awake and responsive to verbal
stimuli.
4
SUCCESS!
McGraw-Hill Emergency medicine Exam Review
(Tintinalli's) EXAM NEWEST VERSION WITH
COMPLETE 600 QUESTIONS AND CORRECT
GUARANTEED ANSWERS JUST RELEASED
A 65-year-old male presents with AMI symptoms after thrombolysis but remains unstable...
The next best course of action would be:
A. Dopamine infusion
B. Nitroglycerin drip
C. Placement of an aortic balloon pump
D. Repeat thrombolytic administration
E. Rescue PCI
Correct answer: E. Rescue PCI
Explanation:
Rescue PCI is indicated when fibrinolysis fails in AMI with persistent pain and hemodynamic
instability.
Which of the following is the BEST answer regarding medication for back pain and sciatica?
A. Cyclobenzaprine (Flexeril) is an appropriate long-term medication for chronic back pain.
B. NSAIDs are an appropriate long-term treatment for chronic low back pain in patients at low
risk of side effects.
C. Opioids are appropriate long-term agents to use for chronic back pain.
D. Steroids are an effective and long-lasting treatment for acute sciatica.
1
SUCCESS!
,Page 2 of 222
E. Tricyclic antidepressants are NOT appropriate long-term medications for use in chronic back
pain.
Correct answer: B. NSAIDs are an appropriate long-term treatment for chronic low back
pain in patients at low risk of side effects.
Explanation:
NSAIDs are effective and appropriate if used cautiously, considering gastrointestinal and renal
risks.
Which of the following methods is NOT an appropriate way to decrease the pain of infiltration
from a local anesthetic?
A. Buffering the anesthetic solution with sodium bicarbonate prior to infiltration
B. Injecting through the wound margins instead of through intact skin
C. Rapid injection to minimize the duration of pain
D. Using 1 mL of sodium bicarbonate 8.4% to buffer 29 mL of bupivacaine 0.25%
E. Warming the solution to body temperature before injecting
Correct answer: C. Rapid injection to minimize the duration of pain
Explanation:
Pain can be minimized by slow injection, warming the solution, injecting through wound
margins, and buffering with sodium bicarbonate. Rapid injection increases discomfort.
What is the MOST common cause of cardiogenic shock?
A. Acute aortic insufficiency
B. Aortic stenosis
C. Hypertrophic cardiomyopathy
D. Acute myocardial infarction (AMI)
E. Pericardial tamponade
2
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,Page 3 of 222
Correct answer: D. Acute myocardial infarction (AMI)
Explanation:
Cardiogenic shock most commonly results from extensive myocardial infarction with loss of
contractility.
Which is TRUE about chronic pain?
A. Chronic pain is more common in elderly patients.
B. Less than 25% of patients whose pain lasts 3 months will continue to have chronic pain for
several years.
C. The goal of emergency treatment should be complete relief of pain.
D. The head is the most common location of chronic pain.
E. Patients presenting to the emergency department because of chronic pain are best helped by
hospital admission.
Correct answer: A. Chronic pain is more common in elderly patients.
Explanation:
Chronic pain is more frequent in the elderly, especially in the back. Complete pain relief is
usually unrealistic; referral to a pain clinic is preferred.
What is the significance of a third heart sound (S3) in the diagnosis of CHF?
A. Absence suggests increased 90-day mortality
B. Absence suggests worse outcome
C. Presence suggests an elevated pulmonary capillary wedge pressure
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, Page 4 of 222
D. Presence suggests improved outcome
E. Presence rules out CHF
Correct answer: C. Presence suggests an elevated pulmonary capillary wedge pressure
Explanation:
An S3 indicates increased left ventricular filling pressures and supports a diagnosis of congestive
heart failure.
An anxious 50-year-old female drug user with a 10-cm thigh abscess... What type of sedation
is this called?
A. Deep sedation
B. Dissociation
C. General anesthesia
D. Minimal sedation
E. Moderate sedation
Correct answer: D. Minimal sedation
Explanation:
Minimal sedation involves anxiolysis with the patient remaining awake and responsive to verbal
stimuli.
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