1|Page
McGraw-Hill Emergency medicine Exam Review
(Tintinalli's), Major Field Test: Political Science
Actual Exam|| Verified Exam!!! Newest With 350
Questions And Correct Answers| Already Graded
A+||Newest Exam!!!
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.
E
Tricyclic antidepressants are NOT appropriate long-term
medications for use in chronic back pain. - Answer-The
correct answer is B. NSAIDs are an appropriate long-
term treatment for chronic low back pain in patients at
low risk of side effects.
Explanation:
Administration of steroids for acute sciatica significantly
reduces pain scores, but the benefit appears to last only
about 24 hours. A systematic meta-analysis of opioids
,2|Page
for chronic back pain found no significant long-term
benefit. Despite some lack of long-term studies, it is
considered reasonable to use NSAIDs in patients with
chronic back pain provided that side effects are
anticipated when the decision is made to prescribe
them. Cyclobenzaprine (Flexeril) appears to have little
benefit beyond that of placebo in chronic back pain.
Tricyclic antidepressants have been shown to improve
mild to moderate chronic back pain.
Which of the following is considered a late finding of
complete arterial obstruction?
A
Hypoesthesia or hyperesthesia
B
Muscle weakness
C
Pain
D
Pallor
E
Paralysis - Answer-The correct answer is E. Paralysis
Explanation:
Paralysis and anesthesia are late findings of ischemic
injury that portend loss of limb viability. An adequate
collateral blood supply may mask signs of ischemia in a
severely diseased artery. Pain can be the sole and
earliest symptom of ischemia in a patient with underlying
peripheral vascular disease. Peripheral nerves and
muscles are very sensitive to ischemia, which causes
early findings of hypesthesia, hyperesthesia, and muscle
weakness. Skin changes associated with complete
,3|Page
arterial obstruction include pallor, cyanosis, petechiae or
blisters, and decreased temperature. Ultimately, skin
and fat necrosis ensue.
71% of users answered correctly.
For which of the following conditions is a tricyclic
antidepressant considered first-line therapy?
A
Complex regional pain syndrome, type I, also known as
reflex sympathetic dystrophy
B
HIV-related neuropathy
C
Phantom limb pain
D
Postherpetic neuralgia
E
Spinal cord injury pain - Answer-The correct answer is
D. Postherpetic neuralgia
Explanation:
In general, tricyclic antidepressants are an effective
therapy in patients with neuropathic pain, which includes
postherpetic neuralgia; however, antidepressants are
not effective for spinal cord injury pain, phantom limb
pain, and HIV-related neuropathy. Intranasal calcitonin
(but no other therapy studied) was recommended by a
meta-analysis for complex regional pain syndrome, type
1.
Which of the following medications should be avoided in
stable patients with a history of heart failure?
A
, 4|Page
Acetaminophen
B
Angiotensin-converting enzyme (ACE) inhibitors
C
Angiotensin receptor blockers
D
Beta-blockers
E
Nonsteroidal anti-inflammatory agents - Answer-The
correct answer is E. Nonsteroidal anti-inflammatory
agents
Explanation:
Nonsteroidal anti-inflammatory agents inhibit the effects
of ACE inhibitors and diuretics and can worsen cardiac
and renal function. The emergency physician (EP)
should review the medication lists of heart failure
patients and also avoid prescribing nonsteroidal anti-
inflammatory drugs (NSAIDs) when such patients
present for injuries or chronic pain. The main risk of
acetaminophen, at excessive levels, is hepatotoxicity.
Stable heart failure patients are discharged on ACE
inhibitors and beta-blockers because these medications
have been conclusively shown to decrease mortality.
Angiotensin receptor blockers have fewer side effects
than ACE inhibitors but can still cause cough or
angioedema.
75% of users answered correctly.
A previously well 25-year-old man presents to the ED
with 3 days of dyspnea, and orthopnea, and a recent
febrile illness associated with myalgias, dyspnea, and
precordial chest pain. Vital signs are BP 124/82, HR
McGraw-Hill Emergency medicine Exam Review
(Tintinalli's), Major Field Test: Political Science
Actual Exam|| Verified Exam!!! Newest With 350
Questions And Correct Answers| Already Graded
A+||Newest Exam!!!
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.
E
Tricyclic antidepressants are NOT appropriate long-term
medications for use in chronic back pain. - Answer-The
correct answer is B. NSAIDs are an appropriate long-
term treatment for chronic low back pain in patients at
low risk of side effects.
Explanation:
Administration of steroids for acute sciatica significantly
reduces pain scores, but the benefit appears to last only
about 24 hours. A systematic meta-analysis of opioids
,2|Page
for chronic back pain found no significant long-term
benefit. Despite some lack of long-term studies, it is
considered reasonable to use NSAIDs in patients with
chronic back pain provided that side effects are
anticipated when the decision is made to prescribe
them. Cyclobenzaprine (Flexeril) appears to have little
benefit beyond that of placebo in chronic back pain.
Tricyclic antidepressants have been shown to improve
mild to moderate chronic back pain.
Which of the following is considered a late finding of
complete arterial obstruction?
A
Hypoesthesia or hyperesthesia
B
Muscle weakness
C
Pain
D
Pallor
E
Paralysis - Answer-The correct answer is E. Paralysis
Explanation:
Paralysis and anesthesia are late findings of ischemic
injury that portend loss of limb viability. An adequate
collateral blood supply may mask signs of ischemia in a
severely diseased artery. Pain can be the sole and
earliest symptom of ischemia in a patient with underlying
peripheral vascular disease. Peripheral nerves and
muscles are very sensitive to ischemia, which causes
early findings of hypesthesia, hyperesthesia, and muscle
weakness. Skin changes associated with complete
,3|Page
arterial obstruction include pallor, cyanosis, petechiae or
blisters, and decreased temperature. Ultimately, skin
and fat necrosis ensue.
71% of users answered correctly.
For which of the following conditions is a tricyclic
antidepressant considered first-line therapy?
A
Complex regional pain syndrome, type I, also known as
reflex sympathetic dystrophy
B
HIV-related neuropathy
C
Phantom limb pain
D
Postherpetic neuralgia
E
Spinal cord injury pain - Answer-The correct answer is
D. Postherpetic neuralgia
Explanation:
In general, tricyclic antidepressants are an effective
therapy in patients with neuropathic pain, which includes
postherpetic neuralgia; however, antidepressants are
not effective for spinal cord injury pain, phantom limb
pain, and HIV-related neuropathy. Intranasal calcitonin
(but no other therapy studied) was recommended by a
meta-analysis for complex regional pain syndrome, type
1.
Which of the following medications should be avoided in
stable patients with a history of heart failure?
A
, 4|Page
Acetaminophen
B
Angiotensin-converting enzyme (ACE) inhibitors
C
Angiotensin receptor blockers
D
Beta-blockers
E
Nonsteroidal anti-inflammatory agents - Answer-The
correct answer is E. Nonsteroidal anti-inflammatory
agents
Explanation:
Nonsteroidal anti-inflammatory agents inhibit the effects
of ACE inhibitors and diuretics and can worsen cardiac
and renal function. The emergency physician (EP)
should review the medication lists of heart failure
patients and also avoid prescribing nonsteroidal anti-
inflammatory drugs (NSAIDs) when such patients
present for injuries or chronic pain. The main risk of
acetaminophen, at excessive levels, is hepatotoxicity.
Stable heart failure patients are discharged on ACE
inhibitors and beta-blockers because these medications
have been conclusively shown to decrease mortality.
Angiotensin receptor blockers have fewer side effects
than ACE inhibitors but can still cause cough or
angioedema.
75% of users answered correctly.
A previously well 25-year-old man presents to the ED
with 3 days of dyspnea, and orthopnea, and a recent
febrile illness associated with myalgias, dyspnea, and
precordial chest pain. Vital signs are BP 124/82, HR
